Healthcare Provider Details

I. General information

NPI: 1093193088
Provider Name (Legal Business Name): SOCORRO YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 TECH CENTER DR
SACRAMENTO CA
95826-2563
US

IV. Provider business mailing address

9343 TECH CENTER DR
SACRAMENTO CA
95826-2563
US

V. Phone/Fax

Practice location:
  • Phone: 916-379-7964
  • Fax:
Mailing address:
  • Phone: 916-441-0226
  • Fax: 916-441-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139321
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: