Bobby Yang

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Practice address

5775 Wayzata Blvd Ste 700
St Louis Park, MN 55416-1233

Phone

(763) 312-1878

NPI assigned

Oct 10, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1972384584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 700",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161233",
            "telephone_number": "763-312-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 700",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161233",
            "telephone_number": "763-312-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "BOBBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyia Wu
• Jennifer Wurdell, MS, CCC-SLP
• Richard A Wyatt
• Kelsey Lynn Wyrd, CNP
• Junqing Xin, MD
• Mai Choua Yang, MA, LMFT
• Siming Yang, L.AC.
• Natalie Lauren Yarbrough, P.T.
• David J Yasmineh, MD
• Justin Yee, M.D.

• Adolescent and Children Mental Health Clinic/Center in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Adolescent and Children Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.