Provider Demographics
NPI:1356096200
Name:LENNAN, YAHSEMIN AYANNA (AMFT)
Entity Type:Individual
Prefix:
First Name:YAHSEMIN
Middle Name:AYANNA
Last Name:LENNAN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14662 RED GUM ST
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4751
Mailing Address - Country:US
Mailing Address - Phone:909-782-1373
Mailing Address - Fax:
Practice Address - Street 1:10630 TOWN CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6806
Practice Address - Country:US
Practice Address - Phone:909-600-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122749106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist