Provider Demographics
NPI:1245414531
Name:PARK, YOOYUEN (PHD, LAC, LE)
Entity Type:Individual
Prefix:DR
First Name:YOOYUEN
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:PHD, LAC, LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 N MARQUIS WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1242
Mailing Address - Country:US
Mailing Address - Phone:925-999-9676
Mailing Address - Fax:925-999-9663
Practice Address - Street 1:39370 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1320
Practice Address - Country:US
Practice Address - Phone:510-797-0500
Practice Address - Fax:510-793-5434
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11853171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist