Healthcare Provider Details

I. General information

NPI: 1336509751
Provider Name (Legal Business Name): AMY YANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY YANG RPH

II. Dates (important events)

Enumeration Date: 02/26/2016
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 CALIFORNIA DR
YOUNTVILLE CA
94599-1411
US

IV. Provider business mailing address

18627 BROOKHURST ST # 504
FOUNTAIN VALLEY CA
92708-6748
US

V. Phone/Fax

Practice location:
  • Phone: 310-310-0230
  • Fax:
Mailing address:
  • Phone: 131-031-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152381
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number54409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: