Provider Demographics
NPI:1386213874
Name:YANG, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
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 1:7413 N CEDAR AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3833
Mailing Address - Country:US
Mailing Address - Phone:559-930-2720
Mailing Address - Fax:559-777-6933
Practice Address - Street 1:7413 N CEDAR AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3833
Practice Address - Country:US
Practice Address - Phone:559-930-2720
Practice Address - Fax:559-777-6933
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst