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General NPI Number Information
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NPI Number | 1205612322
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Entity Type | Organization
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Legal Business Name | JENNIFER YANG PSYCHOLOGIST P.C.
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 613 4TH ST STE 208
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City | SANTA ROSA
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State | CA
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Zip | 95404-4457
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Country | US
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Telephone | 707-302-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 613 4TH ST STE 208
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City | SANTA ROSA
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State | CA
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Zip | 95404-4457
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER YANG
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Credential | PSY.D.
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Telephone | 707-302-8839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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