=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225992985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PHOEBE YANG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3333 CONCOURS STE 4102
-----------------------------------------------------
City | ONTARIO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91764-6564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-240-1764
-----------------------------------------------------
Fax | 909-259-2369
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1947 ANNANDALE WAY
-----------------------------------------------------
City | POMONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91767-3561
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-988-3817
-----------------------------------------------------
Fax | 626-988-3817
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------