Provider Demographics
NPI:1134467020
Name:SEJIMA, YOSHIE (IMF 72618)
Entity Type:Individual
Prefix:MS
First Name:YOSHIE
Middle Name:
Last Name:SEJIMA
Suffix:
Gender:F
Credentials:IMF 72618
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E 3RD ST
Mailing Address - Street 2:SUITE G-106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1494
Mailing Address - Country:US
Mailing Address - Phone:213-473-1648
Mailing Address - Fax:
Practice Address - Street 1:231 E 3RD ST
Practice Address - Street 2:SUITE G-106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1494
Practice Address - Country:US
Practice Address - Phone:213-473-1648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF72618106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1512013461Medicaid
CA1512013461Medicare UPIN
CA1512013461Medicaid