Provider Demographics
NPI:1649094434
Name:PSYAN, LLC
Entity type:Organization
Organization Name:PSYAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANHONG
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:510-499-2175
Mailing Address - Street 1:6460 FARALLON WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1200
Mailing Address - Country:US
Mailing Address - Phone:341-203-5888
Mailing Address - Fax:
Practice Address - Street 1:6460 FARALLON WAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-1200
Practice Address - Country:US
Practice Address - Phone:341-203-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty