Healthcare Provider Details

I. General information

NPI: 1942370986
Provider Name (Legal Business Name): MISS KA KI YIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 INDIANA ST
SAN FRANCISCO CA
94107-3406
US

IV. Provider business mailing address

1116 LORD NELSON LN
FOSTER CITY CA
94404-3640
US

V. Phone/Fax

Practice location:
  • Phone: 415-828-9675
  • Fax:
Mailing address:
  • Phone: 408-480-9550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: