Provider Demographics
NPI:1093424889
Name:YEO, INYOUNG STELLA (PA)
Entity type:Individual
Prefix:
First Name:INYOUNG
Middle Name:STELLA
Last Name:YEO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:
Other - Last Name:YEO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:159 W SANTA CRUZ WAY
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1178
Mailing Address - Country:US
Mailing Address - Phone:714-618-3325
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHGATE DR STE 102
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-3161
Practice Address - Country:US
Practice Address - Phone:209-722-4842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64419363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant