Provider Demographics
NPI:1720546997
Name:YASHOUA, AREZOU (LMFT)
Entity Type:Individual
Prefix:
First Name:AREZOU
Middle Name:
Last Name:YASHOUA
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 1:3841 MENTONE AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3159
Mailing Address - Country:US
Mailing Address - Phone:310-210-3337
Mailing Address - Fax:
Practice Address - Street 1:6200 WILSHIRE BLVD STE 1010
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5811
Practice Address - Country:US
Practice Address - Phone:310-210-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty