MEDICARE: HYE YUN NA RN.BSN.IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	95074426	CA
2	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1295314912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYE YUN NA RN.BSN.IBCLC

Provider Business Mailing Address
First Line	:	1214 W COMMONWEALTH AVE APT C
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-2700
Country	:	US
Telephone Number	:	714-644-8886
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 W COMMONWEALTH AVE APT C
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-2700
Country	:	US
Telephone Number	:	714-644-8886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	05/04/2026

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