Provider Demographics
NPI:1942841267
Name:LIU, YAN LI (FNP)
Entity Type:Individual
Prefix:
First Name:YAN
Middle Name:LI
Last Name:LIU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 GUINEVERE CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3644
Mailing Address - Country:US
Mailing Address - Phone:626-991-6459
Mailing Address - Fax:
Practice Address - Street 1:2373 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4613
Practice Address - Country:US
Practice Address - Phone:626-536-1602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007629363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily