Provider Demographics
NPI:1114380458
Name:YUN, STELLA MINA (LICENSED MFT)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:MINA
Last Name:YUN
Suffix:
Gender:F
Credentials:LICENSED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15350 SHERMAN WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4458
Mailing Address - Country:US
Mailing Address - Phone:818-267-1100
Mailing Address - Fax:818-267-1199
Practice Address - Street 1:15350 SHERMAN WAY STE 200
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4458
Practice Address - Country:US
Practice Address - Phone:818-267-1100
Practice Address - Fax:818-267-1199
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist