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General NPI Number Information
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NPI Number | 1780701888
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Entity Type | Individual
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Provider Name | QUYEN JASY YIN NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1100 N STATE ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-5000
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Country | US
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Telephone | 323-409-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 12102 EASTMAN ST
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City | CERRITOS
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State | CA
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Zip | 90703-6927
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Country | US
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Telephone | 714-658-9269
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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 | 16074
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License Number State | CA
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