Provider Demographics
NPI:1740406826
Name:YACHZEL, BETSY RUTH (PHD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:RUTH
Last Name:YACHZEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12743 STANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1737
Mailing Address - Country:US
Mailing Address - Phone:310-745-0827
Mailing Address - Fax:310-745-0829
Practice Address - Street 1:9100 WILSHIRE BLVD STE 844W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3464
Practice Address - Country:US
Practice Address - Phone:310-859-1232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP11066Medicare ID - Type UnspecifiedPSYCHOLOGIST