Provider Demographics
NPI:1477125664
Name:YEM, DARA
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:YEM
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 1:1087 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-2105
Mailing Address - Country:US
Mailing Address - Phone:562-505-9584
Mailing Address - Fax:
Practice Address - Street 1:2501 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2708
Practice Address - Country:US
Practice Address - Phone:562-424-6105
Practice Address - Fax:562-427-1678
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)