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General NPI Number Information
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NPI Number | 1356206437
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Entity Type | Organization
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Legal Business Name | LUNAR WAVE PSYCHOLOGICAL SERVICES INC.
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 19712 MACARTHUR BLVD STE 110
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City | IRVINE
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State | CA
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Zip | 92612-2407
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Country | US
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Telephone | 949-236-7643
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Fax |
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Provider Business Mailing Address
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Address Line | 4655 CASS ST STE 406
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City | SAN DIEGO
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State | CA
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Zip | 92109-2812
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Country | US
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Telephone | 858-483-9200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREN ASHLEY YANG
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Credential | PSYD
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Telephone | 949-236-7643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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