Provider Demographics
NPI: | 1467975425 |
---|---|
Name: | YANG, MAI SEE (MS) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | MAI |
Middle Name: | SEE |
Last Name: | YANG |
Suffix: | |
Gender: | F |
Credentials: | MS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4441 E KINGS CANYON RD |
Mailing Address - Street 2: | |
Mailing Address - City: | FRESNO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93702-3604 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 559-600-9180 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4441 E KINGS CANYON RD |
Practice Address - Street 2: | |
Practice Address - City: | FRESNO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93702-3604 |
Practice Address - Country: | US |
Practice Address - Phone: | 559-600-9180 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2017-07-21 |
Last Update Date: | 2024-03-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 125290 | 106H00000X |
101YM0800X, 171M00000X, 101Y00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator |