Provider Demographics
NPI:1619049285
Name:YU, VIKKI V (OD)
Entity Type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:V
Last Name:YU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MINOR HALL
Mailing Address - Street 2:UC BERKELEY SCHOOL OF OPTOMETRY
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720
Mailing Address - Country:US
Mailing Address - Phone:510-642-0945
Mailing Address - Fax:
Practice Address - Street 1:230 MINOR HALL
Practice Address - Street 2:UC BERKELEY SCHOOL OF OPTOMETRY
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720
Practice Address - Country:US
Practice Address - Phone:510-642-0945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11244TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0112440Medicaid
CASD0112440Medicaid
CASD0112440Medicaid