Provider Demographics
NPI:1083823066
Name:BLOOMSTEIN, YOLANDE (PHD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDE
Middle Name:
Last Name:BLOOMSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:YOLANDE
Other - Middle Name:BLOOMSTEIN
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:392 NORCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2526
Mailing Address - Country:US
Mailing Address - Phone:310-446-0480
Mailing Address - Fax:310-446-0496
Practice Address - Street 1:392 NORCROFT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2526
Practice Address - Country:US
Practice Address - Phone:310-446-0480
Practice Address - Fax:310-446-0496
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS180531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical