Provider Demographics
NPI:1881110575
Name:CHU-TAKYI, YANI WIN (PSYD)
Entity type:Individual
Prefix:
First Name:YANI
Middle Name:WIN
Last Name:CHU-TAKYI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:YANI
Other - Middle Name:WIN
Other - Last Name:CHU-RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:P.O. BOX 3321
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-224-5577
Mailing Address - Fax:
Practice Address - Street 1:3951 RUBY STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-224-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34345101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health