Healthcare Provider Details

I. General information

NPI: 1669721643
Provider Name (Legal Business Name): ANNA YANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W OLIVE AVE # 1021
MERCED CA
95348-3134
US

IV. Provider business mailing address

20 W OLIVE AVE # 1021
MERCED CA
95348-3134
US

V. Phone/Fax

Practice location:
  • Phone: 209-720-4181
  • Fax:
Mailing address:
  • Phone: 209-720-4181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number87444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: