Healthcare Provider Details

I. General information

NPI: 1114822103
Provider Name (Legal Business Name): HANG YU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOPHIA YU

II. Dates (important events)

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

III. Provider practice location address

11707 BOWMAN GREEN DR
RESTON VA
20190-3501
US

IV. Provider business mailing address

25630 CREEK RUN TER
CHANTILLY VA
20152-6301
US

V. Phone/Fax

Practice location:
  • Phone: 571-251-2631
  • Fax:
Mailing address:
  • Phone: 202-766-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001284
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: