Provider Demographics
NPI:1750770947
Name:YU, CECILLE SUZETTE (RN)
Entity type:Individual
Prefix:
First Name:CECILLE SUZETTE
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUZETTE
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18080 IMPERIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886
Mailing Address - Country:US
Mailing Address - Phone:626-214-6629
Mailing Address - Fax:
Practice Address - Street 1:18080 IMPERIAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886
Practice Address - Country:US
Practice Address - Phone:888-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2018-07-20
Deactivation Date:2018-07-13
Deactivation Code:
Reactivation Date:2018-07-20
Provider Licenses
StateLicense IDTaxonomies
CA851777163W00000X
CA95009255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse