Provider Demographics
NPI:1548594112
Name:YANG, JIE XU (RD)
Entity Type:Individual
Prefix:
First Name:JIE
Middle Name:XU
Last Name:YANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JADE
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:101 THE CITY DR S
Mailing Address - Street 2:NUTRITION SERVICES, NUH BUILDING 1, ROOM 1823
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:714-456-7584
Mailing Address - Fax:714-456-8181
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:NUTRITION SERVICES, NUH BUILDING 1, ROOM 1823
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-7584
Practice Address - Fax:714-456-8181
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered