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NPI Code Detail

MEDICARE: STACEY J YUN

MEDICARE: STACEY J YUN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist145765CA

General Provider Information

NPI Number : 1972174738
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY J YUN
Provider Business Mailing Address
First Line : 550 S GRAMERCY PL APT 107
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-4997
Country : US
Telephone Number : 213-999-6916
Fax Number :
Provider Business Practice Location Address
First Line : 8919 CALIFORNIA AVE
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-3013
Country : US
Telephone Number : 213-999-6916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2021
Last Update Date : 01/03/2025

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Directions to “ STACEY J YUN ” Practice Location

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