Healthcare Provider Details

I. General information

NPI: 1417027400
Provider Name (Legal Business Name): RICHARD YAO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9163 W FLAMINGO RD SUITE 120
LAS VEGAS NV
89147-6457
US

IV. Provider business mailing address

9163 W FLAMINGO RD SUITE 120
LAS VEGAS NV
89147-6457
US

V. Phone/Fax

Practice location:
  • Phone: 702-220-5776
  • Fax: 702-869-9203
Mailing address:
  • Phone: 702-220-5776
  • Fax: 702-869-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY0633
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: