1205924727 NPI number — NATALIE JUDY YESCHIN

Table of content: DR. EDUARDO ONG CUA JR. PSYD (NPI 1679747984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205924727 NPI number — NATALIE JUDY YESCHIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YESCHIN
Provider First Name:
NATALIE
Provider Middle Name:
JUDY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YESCHIN
Provider Other First Name:
NATALIE
Provider Other Middle Name:
JUDY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205924727
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 MARIN ST
Provider Second Line Business Mailing Address:
124-D
Provider Business Mailing Address City Name:
THOUSAND OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91360-4261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-373-8365
Provider Business Mailing Address Fax Number:
805-373-8367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 MARIN ST
Provider Second Line Business Practice Location Address:
124-D
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360-4261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-373-8365
Provider Business Practice Location Address Fax Number:
805-373-8367
Provider Enumeration Date:
10/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS 20417 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DMH 02264 . This is a "LA COUNTY DMH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".