Provider Demographics
NPI:1992465900
Name:YEOH, JACQUES RONG SEN
Entity type:Individual
Prefix:
First Name:JACQUES
Middle Name:RONG SEN
Last Name:YEOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N 1ST ST APT B
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1361
Mailing Address - Country:US
Mailing Address - Phone:424-527-1606
Mailing Address - Fax:
Practice Address - Street 1:537 W 8TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3119
Practice Address - Country:US
Practice Address - Phone:310-834-1198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-19
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator