Provider Demographics
NPI:1659411841
Name:IEVLEVA, YULIA OLEGOVNA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:YULIA
Middle Name:OLEGOVNA
Last Name:IEVLEVA
Suffix:
Gender:F
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:PO BOX 1745
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-1745
Mailing Address - Country:US
Mailing Address - Phone:657-246-2552
Mailing Address - Fax:
Practice Address - Street 1:11721 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3674
Practice Address - Country:US
Practice Address - Phone:562-942-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2024-03-07
Deactivation Date:2009-05-05
Deactivation Code:
Reactivation Date:2013-09-26
Provider Licenses
StateLicense IDTaxonomies
CALMFT48839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist