Healthcare Provider Details

I. General information

NPI: 1063638294
Provider Name (Legal Business Name): MILLIE L. YAU R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JEFFERSON BLVD STE B170
WEST SACRAMENTO CA
95605-2393
US

IV. Provider business mailing address

10 GATEHOUSE CT
SACRAMENTO CA
95826-1770
US

V. Phone/Fax

Practice location:
  • Phone: 916-375-6380
  • Fax:
Mailing address:
  • Phone: 916-383-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN236285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: