Provider Demographics
NPI:1740396977
Name:MOSES, YAEL (MS MFT)
Entity Type:Individual
Prefix:MS
First Name:YAEL
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2036
Mailing Address - Country:US
Mailing Address - Phone:510-644-2990
Mailing Address - Fax:
Practice Address - Street 1:3031 TELEGRAPH AVE STE 143
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2052
Practice Address - Country:US
Practice Address - Phone:510-813-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21694106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist