MEDICARE: DORIS YEUNG M.A. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	28020	CA

General Provider Information

NPI Number	:	1346002029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIS YEUNG M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	1207 SIERRA VILLAGE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95132-2773
Country	:	US
Telephone Number	:	408-598-7568
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 SIERRA VILLAGE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95132-2773
Country	:	US
Telephone Number	:	408-598-7568
Fax Number	:

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

Provider Enumeration Date	:	01/29/2024
Last Update Date	:	01/29/2024

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