Healthcare Provider Details

I. General information

NPI: 1023165248
Provider Name (Legal Business Name): CHALEE YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3147 N MILLBROOK AVE
FRESNO CA
93703-1425
US

IV. Provider business mailing address

3147 N MILLBROOK AVE
FRESNO CA
93703-1425
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-3860
  • Fax: 559-453-5700
Mailing address:
  • Phone: 559-453-3860
  • Fax: 559-453-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: