Provider Demographics
NPI:1598496770
Name:DAI, YUANYUAN
Entity Type:Individual
Prefix:
First Name:YUANYUAN
Middle Name:
Last Name:DAI
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 1:225 HYDE ST APT 510
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 8TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6526
Practice Address - Country:US
Practice Address - Phone:510-735-3900
Practice Address - Fax:510-735-3941
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker