Healthcare Provider Details

I. General information

NPI: 1740616606
Provider Name (Legal Business Name): RONDY YU PHD, LP, LEP, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

991 E MONTE VISTA AVE STE 2
TURLOCK CA
95382-0637
US

IV. Provider business mailing address

2108 N ST # 12216
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 209-353-1877
  • Fax:
Mailing address:
  • Phone: 209-353-1877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number30539
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number30539
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number30539
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number30539
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3412
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-10028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: