Provider Demographics
NPI:1659713329
Name:YU, JEWELEEH HANH (PA-C)
Entity Type:Individual
Prefix:
First Name:JEWELEEH
Middle Name:HANH
Last Name:YU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JEWELEEH
Other - Middle Name:HANH
Other - Last Name:TIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 210271
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-0271
Mailing Address - Country:US
Mailing Address - Phone:916-595-2078
Mailing Address - Fax:
Practice Address - Street 1:2542 S BASCOM AVE
Practice Address - Street 2:STE 110
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-5526
Practice Address - Country:US
Practice Address - Phone:408-559-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23090363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical