Provider Demographics
NPI:1508329566
Name:YU, DEREK (LMFT)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W 6TH ST APT 1417
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-5019
Mailing Address - Country:US
Mailing Address - Phone:213-326-7779
Mailing Address - Fax:
Practice Address - Street 1:520 S LA FAYETTE PARK PL FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1607
Practice Address - Country:US
Practice Address - Phone:213-252-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT142704106H00000X, 106H00000X
CAAMFT120544106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program