Provider Demographics
NPI:1467926477
Name:YEH, STEPHANIE HWANYING (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:HWANYING
Last Name:YEH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HILLSDALE MALL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3407
Mailing Address - Country:US
Mailing Address - Phone:650-769-5612
Mailing Address - Fax:
Practice Address - Street 1:46 HILLSDALE MALL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3407
Practice Address - Country:US
Practice Address - Phone:650-769-5612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56074363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant