Basic Information
| Provider Information | |||||||||
| NPI: | 1679944516 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAI | ||||||||
| FirstName: | SUM YIN EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 281 N MADISON AVE APT 430 | ||||||||
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| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911014467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263549081 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2500 E FOOTHILL BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911073464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269933000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2015 | ||||||||
| LastUpdateDate: | 09/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMF90239 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 225400000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | 106H00000X | 109297 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.