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General NPI Number Information
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NPI Number | 1346301868
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Entity Type | Individual
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Provider Name | JANE GYU YOUNG TSANG MA COUNSELING
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 24255 PACIFIC COAST HWY
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City | MALIBU
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State | CA
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Zip | 90263-3999
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Country | US
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Telephone | 310-506-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 700 S ARDMORE AVE UNIT 702
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City | LOS ANGELES
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State | CA
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Zip | 90005-2430
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Country | US
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Telephone | 408-234-8313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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