MEDICARE: ERIC T. YEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	160141	CA

General Provider Information

NPI Number	:	1265361075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC T. YEN

Provider Business Mailing Address
First Line	:	1626 1/2 S. LA BREA AVENUE
Second Line	:
City	:	LOS ANGELES(999)-999-9999 EXTENSIONEXTE
State	:	CA
Zip	:	90019
Country	:	US
Telephone Number	:	323-528-7066
Fax Number	:

Provider Business Practice Location Address
First Line	:	5615 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-3835
Country	:	US
Telephone Number	:	323-528-7066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ ERIC T. YEN ” Practice Location

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