Provider Demographics
NPI:1396397626
Name:LI, YINGYUE (LCGC, SCM, MS)
Entity type:Individual
Prefix:
First Name:YINGYUE
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:LCGC, SCM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ROYALTY DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3021
Mailing Address - Country:US
Mailing Address - Phone:909-630-7801
Mailing Address - Fax:415-375-4814
Practice Address - Street 1:1910 ROYALTY DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3021
Practice Address - Country:US
Practice Address - Phone:909-630-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC001127170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS