Provider Demographics
NPI:1659349777
Name:LU, YEN YING JEAN (CRNA)
Entity Type:Individual
Prefix:
First Name:YEN YING JEAN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17501 MORRO DR
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-4128
Mailing Address - Country:US
Mailing Address - Phone:626-922-1819
Mailing Address - Fax:866-850-6800
Practice Address - Street 1:17501 MORRO DR
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748
Practice Address - Country:US
Practice Address - Phone:626-912-7472
Practice Address - Fax:866-850-6800
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2464367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALIC2464OtherBCBS
CARN4530050Medicaid
CARN4530050Medicaid