Provider Demographics
NPI:1629602941
Name:YAN, AIMEE Y (RD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:Y
Last Name:YAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 OAK HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6367
Mailing Address - Country:US
Mailing Address - Phone:650-388-0487
Mailing Address - Fax:
Practice Address - Street 1:930 4TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-1628
Practice Address - Country:US
Practice Address - Phone:415-974-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered