Provider Demographics
NPI:1891019238
Name:YASUI, JULIE WENCHU YAN (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:WENCHU YAN
Last Name:YASUI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:WENCHU
Other - Middle Name:YAN
Other - Last Name:YASUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6041 CADILLAC AVE
Mailing Address - Street 2:CARDIOLOGY DEPT., SOCAL PERMANENTE MEDICAL GROUP
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1702
Mailing Address - Country:US
Mailing Address - Phone:323-857-2000
Mailing Address - Fax:323-857-2904
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:CARDIOLOGY DEPT., SOCAL PERMANENTE MEDICAL GROUP
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-2000
Practice Address - Fax:323-857-2904
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner