Provider Demographics
NPI:1578219671
Name:HASARA, YALDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:YALDA
Middle Name:
Last Name:HASARA
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:PO BOX 3561
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91359-0561
Mailing Address - Country:US
Mailing Address - Phone:747-334-2352
Mailing Address - Fax:
Practice Address - Street 1:400 W VENTURA BLVD STE 145
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9139
Practice Address - Country:US
Practice Address - Phone:747-334-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1068681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical