Healthcare Provider Details

I. General information

NPI: 1235078635
Provider Name (Legal Business Name): YU JUNG LIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YU-JUNG LIN

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MARIN ST STE 225
THOUSAND OAKS CA
91360-4301
US

IV. Provider business mailing address

501 MARIN ST STE 225
THOUSAND OAKS CA
91360-4301
US

V. Phone/Fax

Practice location:
  • Phone: 213-291-7999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12511
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: