Healthcare Provider Details
I. General information
NPI: 1154533487
Provider Name (Legal Business Name): CHERRY Y LEUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/07/2007
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 PARNASSUS AVE
SAN FRANCISCO CA
94117-3608
US
IV. Provider business mailing address
350 PARNASSUS AVE
SAN FRANCISCO CA
94117-3608
US
V. Phone/Fax
- Phone: 415-353-2119
- Fax:
- Phone: 415-353-2119
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | NP17194 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | NP17194 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: