Individual provider Active NPI

Yooyuen Park, PH.D., L.AC., L.E.

  • Acupuncturist
  • Fremont, CA
National Provider Identifier
1245414531
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11853 Issued in CA
Practice address
39370 Fremont Blvd
Fremont, CA 94538-1320
Phone
(510) 797-0500
Fax
(510) 793-5434
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11853 CA Primary

Addresses

Primary practice location

39370 Fremont Blvd
Fremont, CA 94538-1320

Mailing address

862 N Marquis Way
Mountain House, CA 95391-1242
Phone (925) 999-9676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AC11853CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1245414531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 N MARQUIS WAY",
            "city": "MOUNTAIN HOUSE",
            "state": "CA",
            "postal_code": "953911242",
            "telephone_number": "925-999-9676",
            "fax_number": "925-999-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39370 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381320",
            "telephone_number": "510-797-0500",
            "fax_number": "510-793-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOOYUEN",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.AC., L.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.