Healthcare Provider Details

I. General information

NPI: 1467425132
Provider Name (Legal Business Name): ROSA M. YEUNG PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 W TOWN AND COUNTRY RD
ORANGE CA
92868-4714
US

IV. Provider business mailing address

956 W TOWN AND COUNTRY RD
ORANGE CA
92868-4714
US

V. Phone/Fax

Practice location:
  • Phone: 714-453-2388
  • Fax: 714-972-3075
Mailing address:
  • Phone: 714-453-2388
  • Fax: 714-972-3075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY17541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: