Provider Demographics
NPI:1568559334
Name:YAU, LUCIA
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:YAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 W ROMNEYA DR STE J
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1815
Mailing Address - Country:US
Mailing Address - Phone:714-533-2117
Mailing Address - Fax:714-533-2131
Practice Address - Street 1:1751 W ROMNEYA DR STE J
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1815
Practice Address - Country:US
Practice Address - Phone:714-348-4901
Practice Address - Fax:714-533-2131
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197221223G0001X
CA480651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92701-01Medicare ID - Type UnspecifiedDENTI-CAL PROVIDER ID