Healthcare Provider Details

I. General information

NPI: 1417233859
Provider Name (Legal Business Name): KARISSA MAI JUN YEE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2011
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 GELLERT BLVD SUITE 150
DALY CITY CA
84015
US

IV. Provider business mailing address

333 GELLERT BLVD SUITE 150
DALY CITY CA
84015
US

V. Phone/Fax

Practice location:
  • Phone: 650-991-7136
  • Fax:
Mailing address:
  • Phone: 510-367-3691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number37467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: