Healthcare Provider Details

I. General information

NPI: 1467366831
Provider Name (Legal Business Name): YI-HSUAN YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVIAN YANG

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CRITTENDEN BLVD
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

300 CRITTENDEN BLVD
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-0807
  • Fax: 585-271-7706
Mailing address:
  • Phone: 585-275-0807
  • Fax: 585-271-7706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: