Provider Demographics
NPI:1922543883
Name:YI, SARAH SHIM (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SHIM
Last Name:YI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N EUCLID ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4131
Mailing Address - Country:US
Mailing Address - Phone:714-517-2100
Mailing Address - Fax:714-490-1973
Practice Address - Street 1:710 N EUCLID ST STE 101
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4131
Practice Address - Country:US
Practice Address - Phone:714-517-2100
Practice Address - Fax:714-490-1973
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily