Provider Demographics
NPI:1225742265
Name:YANG, KAPLAN CHINU
Entity Type:Individual
Prefix:
First Name:KAPLAN
Middle Name:CHINU
Last Name:YANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 GLACIER POINT DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3466
Mailing Address - Country:US
Mailing Address - Phone:209-405-1503
Mailing Address - Fax:
Practice Address - Street 1:8808 GLACIER POINT DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3466
Practice Address - Country:US
Practice Address - Phone:209-405-1503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst