Provider Demographics
NPI:1144841735
Name:WOO LEE, YESSIKA XUEXIA (DPM)
Entity type:Individual
Prefix:
First Name:YESSIKA
Middle Name:XUEXIA
Last Name:WOO LEE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LAS GALLINAS AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3431
Mailing Address - Country:US
Mailing Address - Phone:917-302-7883
Mailing Address - Fax:
Practice Address - Street 1:750 LAS GALLINAS AVE STE 115
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3431
Practice Address - Country:US
Practice Address - Phone:415-472-5575
Practice Address - Fax:415-472-0502
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5936213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist