Basic Information
| Provider Information | |||||||||
| NPI: | 1417401563 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DU | ||||||||
| FirstName: | YAO | ||||||||
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| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 BERTOLONE CT | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951223181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153413883 | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 W 39TH AVE | ||||||||
| Address2: | |||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 944034364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505732222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2016 | ||||||||
| LastUpdateDate: | 08/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 22928 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.