Provider Demographics
NPI:1437305760
Name:FAN, YU-YING (LAC)
Entity Type:Individual
Prefix:MS
First Name:YU-YING
Middle Name:
Last Name:FAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 LYNWOOD TER
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7847
Mailing Address - Country:US
Mailing Address - Phone:408-887-8714
Mailing Address - Fax:
Practice Address - Street 1:1630 OAKLAND RD
Practice Address - Street 2:SUITE A205
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2449
Practice Address - Country:US
Practice Address - Phone:408-887-8714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7237171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist