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General NPI Number Information
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NPI Number | 1295406502
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Entity Type | Individual
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Provider Name | SOOJUNG YOO NP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2021
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 535 N ALAMEDA ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-3405
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Country | US
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Telephone | 213-485-0439
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 W OLYMPIC BLVD STE 217
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City | LOS ANGELES
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State | CA
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Zip | 90006-6507
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Country | US
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Telephone | 213-550-2159
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021611
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95021611
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95106752
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License Number State | CA
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