Provider Demographics
NPI:1003948902
Name:LITTLE, MYA YVETTE
Entity Type:Individual
Prefix:
First Name:MYA
Middle Name:YVETTE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 SHERMAN WAY APT 127
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4055
Mailing Address - Country:US
Mailing Address - Phone:818-915-4999
Mailing Address - Fax:
Practice Address - Street 1:16000 SHERMAN WAY APT 127
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4055
Practice Address - Country:US
Practice Address - Phone:818-901-4836
Practice Address - Fax:818-376-0044
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1060631041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical