Provider Demographics
NPI:1386712396
Name:YANG, YING KAREN (LAC)
Entity type:Individual
Prefix:DR
First Name:YING
Middle Name:KAREN
Last Name:YANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:Y
Other - Last Name:MAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3246 JUDAH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1366
Mailing Address - Country:US
Mailing Address - Phone:415-759-7897
Mailing Address - Fax:415-759-6396
Practice Address - Street 1:3246 JUDAH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1366
Practice Address - Country:US
Practice Address - Phone:415-759-7897
Practice Address - Fax:415-759-6396
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5084171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6945030Medicaid