Provider Demographics
NPI:1245633171
Name:YU, HEE-SEON (WNHP-BC)
Entity type:Individual
Prefix:MS
First Name:HEE-SEON
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:WNHP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S FETTERLY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1605
Mailing Address - Country:US
Mailing Address - Phone:661-932-2813
Mailing Address - Fax:
Practice Address - Street 1:245 S FETTERLY AVE
Practice Address - Street 2:
Practice Address - City:EAST LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1605
Practice Address - Country:US
Practice Address - Phone:661-932-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001501363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health