Provider Demographics
NPI:1679914501
Name:CHOU, LYDIA LEE (NP)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:LEE
Last Name:CHOU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:YEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5725 W LAS POSITAS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4007
Mailing Address - Country:US
Mailing Address - Phone:925-734-8130
Mailing Address - Fax:925-225-9520
Practice Address - Street 1:5725 W LAS POSITAS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4007
Practice Address - Country:US
Practice Address - Phone:925-734-8130
Practice Address - Fax:925-225-9520
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR181999363LF0000X
CA95021375363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily