Provider Demographics
NPI:1720308042
Name:YOO, JENNIFER MIHEE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MIHEE
Last Name:YOO
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 1:540 S. CATALINA ST.
Mailing Address - Street 2:#516
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020
Mailing Address - Country:US
Mailing Address - Phone:213-841-6218
Mailing Address - Fax:
Practice Address - Street 1:12626 RIVERSIDE DR.
Practice Address - Street 2:STE 301
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607
Practice Address - Country:US
Practice Address - Phone:818-760-0110
Practice Address - Fax:818-760-0137
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13198171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist