Provider Demographics
NPI:1598158206
Name:KOAY, SEOKHOOI (RN, CDE)
Entity Type:Individual
Prefix:MS
First Name:SEOKHOOI
Middle Name:
Last Name:KOAY
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35557 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-7605
Mailing Address - Country:US
Mailing Address - Phone:510-676-8614
Mailing Address - Fax:
Practice Address - Street 1:35557 TERRACE DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-7605
Practice Address - Country:US
Practice Address - Phone:510-676-8614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN762386133NN1002X
CA95015755363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education