Individual
MICHELLE LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 E EL CAMINO REAL, MOUNTAIN VIEW, CA 94040-2833
(650) 934-7956
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
648293
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
NP95000678
CA
Other
Enumeration date
07/11/2013
Last updated
03/06/2024
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