Provider Demographics
NPI:1487118576
Name:CARNEY, YAN LI (ACSW)
Entity type:Individual
Prefix:
First Name:YAN
Middle Name:LI
Last Name:CARNEY
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:YAN
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW
Mailing Address - Street 1:28594 SUMMER LN
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7426
Mailing Address - Country:US
Mailing Address - Phone:626-389-7133
Mailing Address - Fax:
Practice Address - Street 1:3625 14TH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3815
Practice Address - Country:US
Practice Address - Phone:951-955-1540
Practice Address - Fax:951-955-1610
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW78787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker