Healthcare Provider Details

I. General information

NPI: 1497598718
Provider Name (Legal Business Name): YONG LI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44750 60TH ST W
LANCASTER CA
93536-7619
US

IV. Provider business mailing address

44750 60TH ST W
LANCASTER CA
93536-7619
US

V. Phone/Fax

Practice location:
  • Phone: 661-729-2000
  • Fax:
Mailing address:
  • Phone: 530-528-2342
  • Fax: 530-690-5457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: