Provider Demographics
NPI:1184255242
Name:SHENG, YANGYANG
Entity type:Individual
Prefix:
First Name:YANGYANG
Middle Name:
Last Name:SHENG
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 1:80 N LAKE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5629
Mailing Address - Country:US
Mailing Address - Phone:626-466-5364
Mailing Address - Fax:626-578-1619
Practice Address - Street 1:80 N LAKE AVE STE 103
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5629
Practice Address - Country:US
Practice Address - Phone:626-466-5364
Practice Address - Fax:626-578-1619
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70465225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist