Healthcare Provider Details

I. General information

NPI: 1083293641
Provider Name (Legal Business Name): YEU MELISSA LO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3790 N 1ST ST
FRESNO CA
93726-5601
US

IV. Provider business mailing address

3790 N 1ST ST
FRESNO CA
93726-5601
US

V. Phone/Fax

Practice location:
  • Phone: 559-890-6111
  • Fax: 559-892-0327
Mailing address:
  • Phone: 559-890-6111
  • Fax: 559-892-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95018176
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number623462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: