Healthcare Provider Details

I. General information

NPI: 1992509798
Provider Name (Legal Business Name): MARCUS WILLIAM YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 CAPITOL AVE
SACRAMENTO CA
95816-6039
US

IV. Provider business mailing address

5458 KAVENY DR
SAN JOSE CA
95129-4117
US

V. Phone/Fax

Practice location:
  • Phone: 916-887-0000
  • Fax:
Mailing address:
  • Phone: 408-823-3697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: