Provider Demographics
NPI:1750918579
Name:YAU, EDWIN (LCSW, MPA, PPS)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:YAU
Suffix:
Gender:M
Credentials:LCSW, MPA, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W VALLEY BLVD # E84
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3338
Mailing Address - Country:US
Mailing Address - Phone:310-256-6398
Mailing Address - Fax:
Practice Address - Street 1:3501 N BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-2856
Practice Address - Country:US
Practice Address - Phone:323-207-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA936351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical