Provider Demographics
NPI:1851022313
Name:YEUNG, KATHLEEN LEI YEE
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:LEI YEE
Last Name:YEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OCEANO
Mailing Address - State:CA
Mailing Address - Zip Code:93445-9045
Mailing Address - Country:US
Mailing Address - Phone:805-215-8166
Mailing Address - Fax:
Practice Address - Street 1:1921 22ND ST
Practice Address - Street 2:
Practice Address - City:OCEANO
Practice Address - State:CA
Practice Address - Zip Code:93445-9045
Practice Address - Country:US
Practice Address - Phone:805-215-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP1600X, 133NN1002X, 172A00000X, 174200000X, 174H00000X, 174N00000X, 374J00000X, 171400000X
CA00000916202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172A00000XOther Service ProvidersDriver
No174200000XOther Service ProvidersMeals
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00000916OtherCPT