Healthcare Provider Details

I. General information

NPI: 1124673801
Provider Name (Legal Business Name): CHENYENG YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 W SHAW AVE STE 100
FRESNO CA
93711-3504
US

IV. Provider business mailing address

1680 W SHAW AVE STE 100
FRESNO CA
93711-3504
US

V. Phone/Fax

Practice location:
  • Phone: 209-465-1080
  • Fax:
Mailing address:
  • Phone: 209-465-1080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: