Healthcare Provider Details

I. General information

NPI: 1689035768
Provider Name (Legal Business Name): YUN-JEONG SEO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 SAND CANYON AVE BLDG 260
IRVINE CA
92618-3714
US

IV. Provider business mailing address

16200 SAND CANYON AVE BLDG 260
IRVINE CA
92618-3714
US

V. Phone/Fax

Practice location:
  • Phone: 347-387-9214
  • Fax: 949-764-4061
Mailing address:
  • Phone: 949-557-0246
  • Fax: 949-764-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF340119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: