Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103G00000X | Clinical Psychologist | PY60227321 | WA |
N | 103TC0700X | Clinical Psychologist | PY60227321 | WA |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TP0016X | Prescribing (Medical) | PY60227321 | WA |
N | 103TP0814X | Psychoanalysis | ||
N | 103TR0400X | Rehabilitation Psychologist | PY60227321 | WA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | PY60227321 | WA |
Y | 2084N0400X | Neurologist | PSY24931 | CA |
NPI | 1033442256 |
---|---|
Provider Name | Maya V Yutsis |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2009 |
Last Update Date | 24/09/2015 |