Healthcare Provider Details

I. General information

NPI: 1871409367
Provider Name (Legal Business Name): SHANGFEN YANG AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6529 CROWN BLVD STE D
SAN JOSE CA
95120-2905
US

IV. Provider business mailing address

6529 CROWN BLVD STE D
SAN JOSE CA
95120-2905
US

V. Phone/Fax

Practice location:
  • Phone: 408-997-0200
  • Fax:
Mailing address:
  • Phone: 408-997-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT165054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: