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NPI Code Detail

MEDICARE: SHANDA H YOON

MEDICARE: SHANDA H YOON
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
1101YM0800XMental Health CounselorIMF74013CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner402162NY

General Provider Information

NPI Number : 1447539978
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANDA H YOON
Provider Business Mailing Address
First Line : 1407 S MICHIGAN AVE APT 1513
Second Line :
City : CHICAGO
State : IL
Zip : 60605-2833
Country : US
Telephone Number : 562-305-3955
Fax Number :
Provider Business Practice Location Address
First Line : 397 BRIDGE ST FL 7
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5247
Country : US
Telephone Number : 646-504-5840
Fax Number : 646-504-5840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2011
Last Update Date : 10/09/2025

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Directions to “ SHANDA H YOON ” Practice Location

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