Provider Demographics
NPI:1851084248
Name:LU, YANYAN (AMFT)
Entity Type:Individual
Prefix:
First Name:YANYAN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 IRENE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-5274
Mailing Address - Country:US
Mailing Address - Phone:201-960-8325
Mailing Address - Fax:
Practice Address - Street 1:141 IRENE CT
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-5274
Practice Address - Country:US
Practice Address - Phone:201-960-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health