Provider Demographics
NPI:1376057117
Name:YU, LISA (ADMINISTRATIVE)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:ADMINISTRATIVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2651
Mailing Address - Country:US
Mailing Address - Phone:415-255-3507
Mailing Address - Fax:
Practice Address - Street 1:1380 HOWARD ST FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2651
Practice Address - Country:US
Practice Address - Phone:415-255-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker