Basic Information
Provider Information
NPI: 1003002197
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUN
FirstName: EUNHWA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: REGISTERED ASW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 SO. LAFAYETTE PARK PLACE 3RD FLOOR
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90057
CountryCode: US
TelephoneNumber: 2132522100
FaxNumber: 2133833146
Practice Location
Address1: 520 SO. LAFAYETTE PARK PLACE 3RD FLOOR
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90057
CountryCode: US
TelephoneNumber: 2132522100
FaxNumber: 2133833146
Other Information
ProviderEnumerationDate: 09/21/2007
LastUpdateDate: 06/24/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XA26170CAY Behavioral Health & Social Service ProvidersSocial Worker 
174400000XMHRSCAN Other Service ProvidersSpecialist 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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