Healthcare Provider Details

I. General information

NPI: 1558880062
Provider Name (Legal Business Name): YANXIA LI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NEAL ST
PLEASANTON CA
94566-7317
US

IV. Provider business mailing address

710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95007960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: