Provider Demographics
NPI:1972033314
Name:YAP, SUE M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:M
Last Name:YAP
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:M
Other - Last Name:TAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1659 KAINS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2923
Mailing Address - Country:US
Mailing Address - Phone:415-269-8729
Mailing Address - Fax:
Practice Address - Street 1:801 TRAEGER AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3048
Practice Address - Country:US
Practice Address - Phone:415-269-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist