Healthcare Provider Details

I. General information

NPI: 1457248056
Provider Name (Legal Business Name): BRIGHTLINE PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
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 TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. RONDY YU
Title or Position: PRESIDENT
Credential: PHD, LP, LEP, BCBA
Phone: 209-353-1877