Provider Demographics
NPI:1639787468
Name:HSIAO, CHENG YANG (AMFT)
Entity type:Individual
Prefix:
First Name:CHENG YANG
Middle Name:
Last Name:HSIAO
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:HSIAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4221 WILSHIRE BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3554
Mailing Address - Country:US
Mailing Address - Phone:626-899-5952
Mailing Address - Fax:
Practice Address - Street 1:11840 MAGNOLIA AVE STE C
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4900
Practice Address - Country:US
Practice Address - Phone:951-465-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health