Provider Demographics
NPI:1962612499
Name:YIN, SOPHAL (MHS)
Entity type:Individual
Prefix:MS
First Name:SOPHAL
Middle Name:
Last Name:YIN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5234 VICTOR AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2152
Mailing Address - Country:US
Mailing Address - Phone:510-869-6049
Mailing Address - Fax:
Practice Address - Street 1:310-8TH STREET
Practice Address - Street 2:201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607
Practice Address - Country:US
Practice Address - Phone:510-869-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator