Provider Demographics
NPI:1710101068
Name:YASNYI, LESLEY B (LMFT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:B
Last Name:YASNYI
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 1:5240 VANTAGE AVE
Mailing Address - Street 2:#104
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-5011
Mailing Address - Country:US
Mailing Address - Phone:818-760-0161
Mailing Address - Fax:
Practice Address - Street 1:330 S OAK KNOLL AVE
Practice Address - Street 2:#210
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3419
Practice Address - Country:US
Practice Address - Phone:626-577-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34283106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist