Provider Demographics
NPI:1275731960
Name:YOON, AELYEN
Entity Type:Individual
Prefix:MS
First Name:AELYEN
Middle Name:
Last Name:YOON
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 1:4380 W 134TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-6034
Mailing Address - Country:US
Mailing Address - Phone:310-519-6210
Mailing Address - Fax:310-732-5809
Practice Address - Street 1:4380 W 134TH ST
Practice Address - Street 2:APT A
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-6034
Practice Address - Country:US
Practice Address - Phone:310-519-6210
Practice Address - Fax:310-732-5809
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA346331163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health