MEDICARE: KRYSTAL YING PSYCHOTHERAPY APC

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1588514996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRYSTAL YING PSYCHOTHERAPY APC

Provider Business Mailing Address
First Line	:	PO BOX 292
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94953-0292
Country	:	US
Telephone Number	:	707-367-3663
Fax Number	:	707-760-7823

Provider Business Practice Location Address
First Line	:	820 GRAVENSTEIN HWY S
Second Line	:	SUITE 200
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472
Country	:	US
Telephone Number	:	707-367-3663
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PSYCHOTHERAPIST
Name	:	KRYSTAL YING
Credential	:	MA
Telephone Number	:	707-367-3663

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/18/2026

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