Provider Demographics
NPI:1679694673
Name:HERMAN, YVONNE DEGRASSE (MFT)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:DEGRASSE
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24031 EL TORO RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3151
Mailing Address - Country:US
Mailing Address - Phone:949-768-6845
Mailing Address - Fax:714-384-3875
Practice Address - Street 1:24031 EL TORO RD
Practice Address - Street 2:250
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3151
Practice Address - Country:US
Practice Address - Phone:949-768-6845
Practice Address - Fax:949-768-5124
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist