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General NPI Number Information
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NPI Number | 1750784567
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Entity Type | Individual
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Provider Name | JIAQI YANG R.D.
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Gender | Female
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 20101 LAKE CHABOT RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5305
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Country | US
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Telephone | 510-886-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 325 DISTEL CIR
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City | LOS ALTOS
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State | CA
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Zip | 94022-1408
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Country | US
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Telephone | 510-727-3032
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1021367
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License Number State | CA
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