Healthcare Provider Details
I. General information
NPI: 1164056008
Provider Name (Legal Business Name): VICTORIA YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/01/2020
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6203 SAN IGNACIO AVE STE 150
SAN JOSE CA
95119-1371
US
IV. Provider business mailing address
6203 SAN IGNACIO AVE STE 150
SAN JOSE CA
95119-1371
US
V. Phone/Fax
- Phone: 408-284-9080
- Fax:
- Phone: 408-284-9080
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: