1366180416 NPI number — ALLISON YUN HEE SOONG ANTALEK MSN, MPH, CPNP-PC

Table of content: DR. JANET EILEEN CONSTANCE PH.D. (NPI 1740516665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366180416 NPI number — ALLISON YUN HEE SOONG ANTALEK MSN, MPH, CPNP-PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANTALEK
Provider First Name:
ALLISON
Provider Middle Name:
YUN HEE SOONG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, MPH, CPNP-PC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOONG
Provider Other First Name:
ALLISON
Provider Other Middle Name:
YUN HEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN, MPH, CPNP-PC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1366180416
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HAVEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94014-2831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-475-7602
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 WELCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94304-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-723-0993
Provider Business Practice Location Address Fax Number:
650-721-6350
Provider Enumeration Date:
05/26/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  95021041 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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