Healthcare Provider Details
I. General information
NPI: 1598602245
Provider Name (Legal Business Name): SHIYU QI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1782 B ST
HAYWARD CA
94541-3102
US
IV. Provider business mailing address
6 AVOCET DR APT 208
REDWOOD CITY CA
94065-2284
US
V. Phone/Fax
- Phone: 510-270-5027
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 164X00000X |
| Taxonomy | Licensed Vocational Nurse |
| License Number | 759546 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: