Provider Demographics
NPI:1629432877
Name:WANG, YUN (PSYD)
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MIDDLESEX AVE # 1089
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1105
Mailing Address - Country:US
Mailing Address - Phone:617-297-7791
Mailing Address - Fax:
Practice Address - Street 1:65 WALDEN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-3325
Practice Address - Country:US
Practice Address - Phone:617-297-7791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical