Healthcare Provider Details

I. General information

NPI: 1922634989
Provider Name (Legal Business Name): TAMMY YAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1993 MCKEE RD
SAN JOSE CA
95116-1406
US

IV. Provider business mailing address

1993 MCKEE RD
SAN JOSE CA
95116-1406
US

V. Phone/Fax

Practice location:
  • Phone: 888-334-1000
  • Fax:
Mailing address:
  • Phone: 888-334-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number183507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: