Provider Demographics
NPI:1477964062
Name:FUNG, PO YEE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:PO
Middle Name:YEE
Last Name:FUNG
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-1924
Mailing Address - Country:US
Mailing Address - Phone:646-283-5391
Mailing Address - Fax:
Practice Address - Street 1:939 ELLIS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-7714
Practice Address - Country:US
Practice Address - Phone:646-283-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007794101YM0800X
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9975OtherBOARD OF BEHAVIORAL SCIENCE
NYP97229OtherNYS OFFICE OF THE PROFESSIONS