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Individual

WEIYA DOUGLAS LU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.,NP,MSN,RN

Contact information

Practice address
3280 E FOOTHILL BLVD, PASADENA, CA 91107-3148
(833) 574-2273
Mailing address
18144 SECO ST, JAMESTOWN, CA 95327-9498
(209) 984-4820
(209) 984-4825

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95070370
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95007305
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95007305
NP-FURNISHING
CA
Enumeration date
08/23/2016
Last updated
10/15/2024
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