Healthcare Provider Details

I. General information

NPI: 1275437535
Provider Name (Legal Business Name): RUOXI YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N KING RD APT 912
SAN JOSE CA
95133-1562
US

IV. Provider business mailing address

750 N KING RD APT 912
SAN JOSE CA
95133-1562
US

V. Phone/Fax

Practice location:
  • Phone: 818-825-0014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86446558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: