Healthcare Provider Details

I. General information

NPI: 1518479682
Provider Name (Legal Business Name): YU-AN WANG, LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 WALNUT GROVE AVE APT H
ROSEMEAD CA
91770-5703
US

IV. Provider business mailing address

1060 WALNUT GROVE AVE APT H
ROSEMEAD CA
91770-5703
US

V. Phone/Fax

Practice location:
  • Phone: 425-686-8927
  • Fax:
Mailing address:
  • Phone: 425-686-8927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberLH60792410
License Number StateWA

VIII. Authorized Official

Name: YU-AN WANG
Title or Position: PRINCIPAL
Credential: LMHC, NCC, MA
Phone: 847-505-3353