Provider Demographics
NPI:1245607134
Name:YOSHIZAWA, YASUNO (MA, MFT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:YASUNO
Middle Name:
Last Name:YOSHIZAWA
Suffix:
Gender:F
Credentials:MA, MFT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 MONTEREY ST. P.O.BOX #4066
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2790 SKYPARK DR STE 305
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5388
Practice Address - Country:US
Practice Address - Phone:310-943-9675
Practice Address - Fax:310-943-9675
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88594106H00000X
CA112040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist