Provider Demographics
NPI:1538323076
Name:YABU, PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:YABU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 FLYING HILLS LN
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-6259
Mailing Address - Country:US
Mailing Address - Phone:805-485-6114
Mailing Address - Fax:
Practice Address - Street 1:1305 DEL NORTE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8436
Practice Address - Country:US
Practice Address - Phone:805-485-6114
Practice Address - Fax:805-973-5325
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS98151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical