Provider Demographics
NPI:1679012116
Name:OSORIO, YVETTE (LMFT)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:OSORIO
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 1:107 N REINO RD # 1037
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-3710
Mailing Address - Country:US
Mailing Address - Phone:805-768-4959
Mailing Address - Fax:
Practice Address - Street 1:521 S OAK ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-2519
Practice Address - Country:US
Practice Address - Phone:805-768-4959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health