Provider Demographics
NPI:1780281493
Name:YU, SYMONE MAGSOMBOL (MS, RN, PHN, CPNP)
Entity type:Individual
Prefix:
First Name:SYMONE
Middle Name:MAGSOMBOL
Last Name:YU
Suffix:
Gender:F
Credentials:MS, RN, PHN, CPNP
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:SYMONE OBA
Other - Last Name:MAGSOMBOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 90TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1879
Mailing Address - Country:US
Mailing Address - Phone:650-877-5700
Mailing Address - Fax:
Practice Address - Street 1:350 90TH ST FL 3
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1879
Practice Address - Country:US
Practice Address - Phone:650-877-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015277363LP0200X, 363LP2300X, 363L00000X
CA95172209163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse