Healthcare Provider Details

I. General information

NPI: 1780281493
Provider Name (Legal Business Name): SYMONE MAGSOMBOL YU MS, RN, PHN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE SYMONE OBA MAGSOMBOL

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 90TH ST FL 3
DALY CITY CA
94015-1879
US

IV. Provider business mailing address

350 90TH ST FL 3
DALY CITY CA
94015-1879
US

V. Phone/Fax

Practice location:
  • Phone: 650-877-5700
  • Fax:
Mailing address:
  • Phone: 650-877-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95015277
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95015277
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95015277
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95172209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: