Healthcare Provider Details

I. General information

NPI: 1215247556
Provider Name (Legal Business Name): NICOLE TINGTING YEUNG B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 POST ST
SAN FRANCISCO CA
94109-5603
US

IV. Provider business mailing address

286 19TH AVE APT C
SAN FRANCISCO CA
94121-2303
US

V. Phone/Fax

Practice location:
  • Phone: 415-775-2636
  • Fax: 415-775-1345
Mailing address:
  • Phone: 415-823-2412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: