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General NPI Number Information
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NPI Number | 1952856502
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Entity Type | Individual
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Provider Name | WEIYA DOUGLAS LU PH.D.,NP,MSN,RN
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Gender | Male
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 3280 E FOOTHILL BLVD
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City | PASADENA
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State | CA
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Zip | 91107-3148
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 18144 SECO ST
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City | JAMESTOWN
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State | CA
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Zip | 95327-9498
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Country | US
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Telephone | 209-984-4820
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Fax | 209-984-4825
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95070370
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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 | 95007305
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License Number State | CA
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