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General NPI Number Information
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NPI Number | 1447539978
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Entity Type | Individual
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Provider Name | SHANDA H YOON
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Gender | Female
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Dates
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Enumeration Date | 08/15/2011
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 397 BRIDGE ST FL 7
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City | BROOKLYN
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State | NY
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Zip | 11201-5247
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Country | US
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Telephone | 646-504-5840
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Fax | 646-504-5840
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Provider Business Mailing Address
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Address Line | 1407 S MICHIGAN AVE APT 1513
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City | CHICAGO
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State | IL
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Zip | 60605-2833
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Country | US
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Telephone | 562-305-3955
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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 | IMF74013
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402162
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License Number State | NY
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