Provider Demographics
NPI:1205953650
Name:YANG, VANG (CMHS)
Entity type:Individual
Prefix:MR
First Name:VANG
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:CMHS
Other - Prefix:MR
Other - First Name:VANG
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4447 E. KINGS CANYON RD MODE E.
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-1425
Mailing Address - Country:US
Mailing Address - Phone:559-600-5986
Mailing Address - Fax:
Practice Address - Street 1:4447 E. KINGS CANYON RD MOD E.
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702
Practice Address - Country:US
Practice Address - Phone:559-600-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA225400000XMedicare ID - Type Unspecified