Provider Demographics
NPI:1285843821
Name:CHANG-ALLEN, YONGCHING (MA CCC-A)
Entity Type:Individual
Prefix:MS
First Name:YONGCHING
Middle Name:
Last Name:CHANG-ALLEN
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 N GARFIELD AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3556
Mailing Address - Country:US
Mailing Address - Phone:626-284-4633
Mailing Address - Fax:626-284-4162
Practice Address - Street 1:41 N GARFIELD AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3556
Practice Address - Country:US
Practice Address - Phone:626-284-4633
Practice Address - Fax:626-284-4162
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1955237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0019550Medicaid
CAAU0019550Medicaid
CAWAUD1955BMedicare ID - Type Unspecified