Healthcare Provider Details

I. General information

NPI: 1669776894
Provider Name (Legal Business Name): KATHERINE YEP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 POLLARD RD
LOS GATOS CA
95032-1438
US

IV. Provider business mailing address

PO BOX 18234
SAN JOSE CA
95158-8234
US

V. Phone/Fax

Practice location:
  • Phone: 408-866-4025
  • Fax:
Mailing address:
  • Phone: 408-784-3177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: