Provider Demographics
NPI:1376694919
Name:WANG, YUNCHUAN (NP)
Entity Type:Individual
Prefix:MISS
First Name:YUNCHUAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JANE
Other - Middle Name:YUNCHUAN
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:120 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-3804
Mailing Address - Country:US
Mailing Address - Phone:650-260-2246
Mailing Address - Fax:
Practice Address - Street 1:801 WELCH RD.
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94035
Practice Address - Country:US
Practice Address - Phone:650-725-6667
Practice Address - Fax:650-725-6685
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF13416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily