Provider Demographics
NPI:1558107227
Name:YANG, STEPHANIE (SLP-CF)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 HAMNER AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3637
Mailing Address - Country:US
Mailing Address - Phone:626-536-4834
Mailing Address - Fax:
Practice Address - Street 1:1761 3RD ST STE 106
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2679
Practice Address - Country:US
Practice Address - Phone:626-536-4834
Practice Address - Fax:626-507-6319
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19349235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist