Provider Demographics
NPI:1043338783
Name:YAN, YOEUN
Entity type:Individual
Prefix:
First Name:YOEUN
Middle Name:
Last Name:YAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-0230
Mailing Address - Country:US
Mailing Address - Phone:209-681-1730
Mailing Address - Fax:209-541-2114
Practice Address - Street 1:1581 CUMMINS DR STE 147
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-6402
Practice Address - Country:US
Practice Address - Phone:209-281-7465
Practice Address - Fax:209-558-4320
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator