Healthcare Provider Details

I. General information

NPI: 1073434908
Provider Name (Legal Business Name): UNDA PSYCHIATRY AND WELLNESS, A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 PACIFIC HEIGHTS BLVD STE 150
SAN DIEGO CA
92121-4361
US

IV. Provider business mailing address

9920 PACIFIC HEIGHTS BLVD STE 150
SAN DIEGO CA
92121-4361
US

V. Phone/Fax

Practice location:
  • Phone: 619-393-9693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHENXI YANG
Title or Position: CEO
Credential: PMHNP-BC
Phone: 619-393-6938