Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 19520 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | 19520 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 19520 | CA |
N | 103G00000X | Clinical Psychologist | 19520 | CA |
N | 103TC0700X | Clinical Psychologist | 19520 | CA |
N | 103TF0200X | Forensic Psychologist | 19520 | CA |
NPI | 1508080284 |
---|---|
Provider Name | Dr. Alex Yan Yufik |
First Address | South Pasadena, CA 91030-4477 |
Second Address | West Hollywood, CA 90048-1732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |