Provider Demographics
NPI:1497377527
Name:NA, YURIANNA HYECHONG (LCSW)
Entity Type:Individual
Prefix:
First Name:YURIANNA
Middle Name:HYECHONG
Last Name:NA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 JACKSON ST APT 501
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-4086
Mailing Address - Country:US
Mailing Address - Phone:951-204-6860
Mailing Address - Fax:
Practice Address - Street 1:1401 JACKSON ST APT 501
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-4086
Practice Address - Country:US
Practice Address - Phone:951-204-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA894581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical