Healthcare Provider Details

I. General information

NPI: 1962296012
Provider Name (Legal Business Name): EMILY SHUANGYUE CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR
VALLEJO CA
94589-2441
US

IV. Provider business mailing address

3470 JANICE WAY
PALO ALTO CA
94303-4212
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-3338
  • Fax:
Mailing address:
  • Phone: 650-799-4199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: