Provider Demographics
NPI:1457419251
Name:CRABB, YANGCHA P (PHD)
Entity Type:Individual
Prefix:DR
First Name:YANGCHA
Middle Name:P
Last Name:CRABB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SOYOUNG
Other - Middle Name:P
Other - Last Name:CRABB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3230 S BUFFALO DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2505
Mailing Address - Country:US
Mailing Address - Phone:702-290-0331
Mailing Address - Fax:702-254-3146
Practice Address - Street 1:3230 S BUFFALO DR
Practice Address - Street 2:SUITE 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2505
Practice Address - Country:US
Practice Address - Phone:702-290-0331
Practice Address - Fax:702-254-3146
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0523103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100514096Medicaid
NV100514096Medicaid