Provider Demographics
NPI:1447430673
Name:ABU-DALU, YASMIN (MFTI)
Entity Type:Individual
Prefix:MISS
First Name:YASMIN
Middle Name:
Last Name:ABU-DALU
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 MEDLEY PL
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4343
Mailing Address - Country:US
Mailing Address - Phone:818-317-1511
Mailing Address - Fax:
Practice Address - Street 1:4408 MEDLEY PL
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4343
Practice Address - Country:US
Practice Address - Phone:818-317-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI 55418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist