Healthcare Provider Details

I. General information

NPI: 1871618249
Provider Name (Legal Business Name): YUAN-SHAN LIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ORANGEFAIR MALL
FULLERTON CA
92832-3038
US

IV. Provider business mailing address

233 ORANGEFAIR MALL
FULLERTON CA
92832-3038
US

V. Phone/Fax

Practice location:
  • Phone: 714-870-6116
  • Fax:
Mailing address:
  • Phone: 714-870-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT 33529
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number33529
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number306332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: