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General NPI Number Information
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NPI Number | 1518497197
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Entity Type | Individual
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Provider Name | SHANA YOUNG YOO
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Gender | Female
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 11940 FOOTHILL BLVD STE 204
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-9376
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Country | US
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Telephone | 626-775-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 663 S INDIAN HILL BLVD APT B
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City | CLAREMONT
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State | CA
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Zip | 91711-5482
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Country | US
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Telephone | 909-979-4963
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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