Healthcare Provider Details

I. General information

NPI: 1720906480
Provider Name (Legal Business Name): MS. JESSA KAILAI YAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE BLDG A10
ALHAMBRA CA
91803-8800
US

IV. Provider business mailing address

314 GERONA AVE
SAN GABRIEL CA
91775-2936
US

V. Phone/Fax

Practice location:
  • Phone: 626-759-9154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: