Provider Demographics
NPI:1962739821
Name:YI, ANGELA SUN-HEE (PHD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUN-HEE
Last Name:YI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 N CLAREMONT BLVD
Mailing Address - Street 2:SUITE 209C
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3528
Mailing Address - Country:US
Mailing Address - Phone:909-480-8065
Mailing Address - Fax:909-626-8222
Practice Address - Street 1:1420 N CLAREMONT BLVD
Practice Address - Street 2:SUITE 209C
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3528
Practice Address - Country:US
Practice Address - Phone:909-480-8065
Practice Address - Fax:909-626-8222
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26281103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist