Healthcare Provider Details

I. General information

NPI: 1336617448
Provider Name (Legal Business Name): NADIA YANG DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 WESTERN AVE
BRIGHTON MA
02135-1007
US

IV. Provider business mailing address

495 WESTERN AVE
BRIGHTON MA
02135-1007
US

V. Phone/Fax

Practice location:
  • Phone: 617-783-0500
  • Fax:
Mailing address:
  • Phone: 617-783-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2381440
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7620
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: