Provider Demographics
NPI:1003654682
Name:LUU, YEN KIM
Entity type:Individual
Prefix:
First Name:YEN
Middle Name:KIM
Last Name:LUU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 SILVER CREEK VALLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138
Mailing Address - Country:US
Mailing Address - Phone:408-574-9100
Mailing Address - Fax:408-574-9235
Practice Address - Street 1:5855 SILVER CREEK VALLEY PLACE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138
Practice Address - Country:US
Practice Address - Phone:408-574-9100
Practice Address - Fax:408-574-9235
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95205023163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse