Healthcare Provider Details

I. General information

NPI: 1528325081
Provider Name (Legal Business Name): RU-TING YANG LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS EMILY YANG

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12912 BROOKHURST ST STE 480
GARDEN GROVE CA
92840-4867
US

IV. Provider business mailing address

19712 MACARTHUR BLVD STE 110
IRVINE CA
92612-2407
US

V. Phone/Fax

Practice location:
  • Phone: 714-636-6286
  • Fax:
Mailing address:
  • Phone: 949-546-7309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF76385
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number112435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: