Healthcare Provider Details

I. General information

NPI: 1396218848
Provider Name (Legal Business Name): PRESTON YUN YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 WESTLAKE CTR STE 204
DALY CITY CA
94015-1437
US

IV. Provider business mailing address

318 WESTLAKE CTR STE 204
DALY CITY CA
94015-1437
US

V. Phone/Fax

Practice location:
  • Phone: 415-579-1638
  • Fax:
Mailing address:
  • Phone: 415-579-1638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: