Provider Demographics
NPI:1750591996
Name:TSE, YUEN KWAN (MFTI)
Entity type:Individual
Prefix:MS
First Name:YUEN
Middle Name:KWAN
Last Name:TSE
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2235
Mailing Address - Country:US
Mailing Address - Phone:510-835-2777
Mailing Address - Fax:510-835-0164
Practice Address - Street 1:255 INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-2235
Practice Address - Country:US
Practice Address - Phone:510-835-2777
Practice Address - Fax:510-835-0164
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52011106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7715OtherINSYST (PSP) STAFF NUMBER