Provider Demographics
NPI:1114274339
Name:HOEKMAN, SHAN-YU (CNM)
Entity Type:Individual
Prefix:
First Name:SHAN-YU
Middle Name:
Last Name:HOEKMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SHAN-YU
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-869-8425
Mailing Address - Fax:510-506-7710
Practice Address - Street 1:350 30TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3424
Practice Address - Country:US
Practice Address - Phone:510-869-8425
Practice Address - Fax:510-506-7710
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60299004367A00000X
CA1036367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACNM1036OtherSTATE MEDICAL LICENSE