Individual provider Active NPI

Soojin Yu, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Norco, CA
National Provider Identifier
1003277260
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95003819 Issued in CA
Practice address
1781 3Rd St
Norco, CA 92860
Phone
(951) 279-4900
NPI assigned
Mar 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95003819 CA Primary

Addresses

Primary practice location

1781 3Rd St
Norco, CA 92860

Mailing address

996 Evening Canyon Rd
Brea, CA 92821-2612
Phone (714) 833-7556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170914001284 CA Practitioner - Nurse Practitioner 1153695168 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95003819CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Family Medical Group, Inc CurrentSince Aug 8, 2017 Accepting new patients
BVC Therapy Group CurrentSince Sep 11, 2022 Accepting new patients
Allcare Family Clinic Inc. CurrentSince Aug 8, 2017 Accepting new patients
St Jude Hospital Inc PastSince Aug 8, 2017 Accepting new patients

Locations

6301 Beach Blvd
Ste 109
Buena Park, CA 90621
Phone (714) 525-9900

1781 3rd St
Norco, CA 92860
Phone (951) 279-4900

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1003277260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 EVENING CANYON RD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212612",
            "telephone_number": "714-833-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 3RD ST",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "92860",
            "telephone_number": "951-279-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SOOJIN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95003819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norco, CA

Sources for this page

Verify at the official NPI Registry.