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NPI Code Detail

MEDICARE: JACQUES RONG SEN YEOH

MEDICARE: JACQUES RONG SEN YEOH
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
1171M00000XCase Manager/Care Coordinator
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1992465900
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUES RONG SEN YEOH
Provider Business Mailing Address
First Line : 119 W TORRANCE BLVD STE 100
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-3600
Country : US
Telephone Number : 310-374-3300
Fax Number : 310-374-3307
Provider Business Practice Location Address
First Line : 537 W 8TH ST
Second Line :
City : SAN PEDRO
State : CA
Zip : 90731-3119
Country : US
Telephone Number : 310-834-1198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2021
Last Update Date : 01/20/2026

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Directions to “ JACQUES RONG SEN YEOH ” Practice Location

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