Provider Demographics
NPI:1154035095
Name:LUO, SHIYING
Entity type:Individual
Prefix:
First Name:SHIYING
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 65TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1053
Mailing Address - Country:US
Mailing Address - Phone:510-929-1400
Mailing Address - Fax:510-929-1414
Practice Address - Street 1:1144 65TH ST STE F
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-1053
Practice Address - Country:US
Practice Address - Phone:510-929-1400
Practice Address - Fax:510-929-1414
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner