Healthcare Provider Details

I. General information

NPI: 1427968890
Provider Name (Legal Business Name): KIA YANG SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27192 NEWPORT RD STE 1
MENIFEE CA
92584-7387
US

IV. Provider business mailing address

27192 NEWPORT RD STE 1
MENIFEE CA
92584-7387
US

V. Phone/Fax

Practice location:
  • Phone: 951-566-4444
  • Fax: 951-566-4475
Mailing address:
  • Phone: 951-566-4444
  • Fax: 951-566-4475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: