Healthcare Provider Details

I. General information

NPI: 1770351884
Provider Name (Legal Business Name): YIJING HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27141 ALISO CREEK RD
ALISO VIEJO CA
92656-3357
US

IV. Provider business mailing address

5 MAREBLU
ALISO VIEJO CA
92656-3014
US

V. Phone/Fax

Practice location:
  • Phone: 949-643-6901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number141208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: