Healthcare Provider Details

I. General information

NPI: 1356464986
Provider Name (Legal Business Name): MR. YENG ANDY VANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 PARMAC RD STE 1
CHICO CA
95926-2218
US

IV. Provider business mailing address

3486 POMOLA AVE
OROVILLE CA
95966-6561
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-2986
  • Fax: 530-895-6549
Mailing address:
  • Phone: 530-533-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: