Healthcare Provider Details
I. General information
NPI: 1467388447
Provider Name (Legal Business Name): YUFENG TIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7600 BALBOA BLVD
VAN NUYS CA
91406-2266
US
IV. Provider business mailing address
22855 15TH ST
NEWHALL CA
91321-1553
US
V. Phone/Fax
- Phone: 818-578-8199
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 88548 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: