1508197930 NPI number — CHRISTINA YANG NBC-HWC, LCSW, LMSW

Table of content: CHRISTINA YANG NBC-HWC, LCSW, LMSW (NPI 1508197930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508197930 NPI number — CHRISTINA YANG NBC-HWC, LCSW, LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANG
Provider First Name:
CHRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NBC-HWC, LCSW, LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508197930
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 283
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORONA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92878-0283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5801 HILLCREST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN PABLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94806-4135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-496-4319
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2010

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: 104100000X , with the licence number:  085265 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 097093 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171400000X , with the licence number: A-3693222 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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