Provider Demographics
NPI:1285298042
Name:YUEN, KEVIN (BA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:YUEN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2515
Mailing Address - Country:US
Mailing Address - Phone:626-812-0055
Mailing Address - Fax:626-334-1227
Practice Address - Street 1:326 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2515
Practice Address - Country:US
Practice Address - Phone:626-812-0055
Practice Address - Fax:626-334-1227
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-19-37671103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician