Healthcare Provider Details

I. General information

NPI: 1740101195
Provider Name (Legal Business Name): ASHLEY YOO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 BRYNLEE PL
UPLAND CA
91786-3546
US

IV. Provider business mailing address

854 BRYNLEE PL
UPLAND CA
91786-3546
US

V. Phone/Fax

Practice location:
  • Phone: 909-407-1119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95438951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: