Provider Demographics
NPI:1689726796
Name:YANG, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:YANG
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 1:2055 ANDERSON RD
Mailing Address - Street 2:STE. C
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1210
Mailing Address - Country:US
Mailing Address - Phone:530-304-8662
Mailing Address - Fax:916-371-3889
Practice Address - Street 1:2055 ANDERSON RD
Practice Address - Street 2:STE. C
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1210
Practice Address - Country:US
Practice Address - Phone:530-304-8662
Practice Address - Fax:916-371-3889
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 211901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical