Provider Demographics
NPI:1225549835
Name:YUZNA, CATHY CHERRY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:CHERRY
Last Name:YUZNA
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 1:1626 WILCOX AVE # 244
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6206
Mailing Address - Country:US
Mailing Address - Phone:323-344-2590
Mailing Address - Fax:
Practice Address - Street 1:1626 WILCOX AVE # 244
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6206
Practice Address - Country:US
Practice Address - Phone:323-344-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122578101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)