Provider Demographics
NPI:1083119648
Name:YANG, NOU
Entity Type:Individual
Prefix:MISS
First Name:NOU
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7273 14TH AVE STE 120B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-3500
Mailing Address - Country:US
Mailing Address - Phone:916-383-6783
Mailing Address - Fax:916-383-8488
Practice Address - Street 1:7273 14TH AVE STE 120B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-3500
Practice Address - Country:US
Practice Address - Phone:916-383-6783
Practice Address - Fax:916-383-8488
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 171M00000X
CAR1203290615101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health