Healthcare Provider Details

I. General information

NPI: 1093462012
Provider Name (Legal Business Name): KEVIN YU MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9891 IRVINE CENTER DR
IRVINE CA
92618-4317
US

IV. Provider business mailing address

9891 IRVINE CENTER DR STE 200
IRVINE CA
92618-4320
US

V. Phone/Fax

Practice location:
  • Phone: 312-270-1314
  • Fax:
Mailing address:
  • Phone: 312-270-1314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166001542
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: