MEDICARE: DR. YANGCHA P. CRABB PH.D

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	103TC0700X	Clinical Psychologist	PY0523	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457419251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YANGCHA P. CRABB PH.D

Provider Business Mailing Address
First Line	:	3230 S BUFFALO DR
Second Line	:	SUITE 107
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2505
Country	:	US
Telephone Number	:	702-290-0331
Fax Number	:	702-254-3146

Provider Business Practice Location Address
First Line	:	3230 S BUFFALO DR
Second Line	:	SUITE 107
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2505
Country	:	US
Telephone Number	:	702-290-0331
Fax Number	:	702-254-3146

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/10/2014

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