Healthcare Provider Details

I. General information

NPI: 1861308462
Provider Name (Legal Business Name): YANSONG HONG LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 W HEDDING ST
SAN JOSE CA
95128-1428
US

IV. Provider business mailing address

2007 W HEDDING ST
SAN JOSE CA
95128-1428
US

V. Phone/Fax

Practice location:
  • Phone: 408-805-4305
  • Fax:
Mailing address:
  • Phone: 408-805-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT158967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: