Provider Demographics
NPI:1104045434
Name:YAMAMOTO, LYNN F Y (MS, MFT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:F Y
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S DIAMOND BAR BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2298
Mailing Address - Country:US
Mailing Address - Phone:909-396-6888
Mailing Address - Fax:909-396-6889
Practice Address - Street 1:1200 S DIAMOND BAR BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2298
Practice Address - Country:US
Practice Address - Phone:909-396-6888
Practice Address - Fax:909-396-6889
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist