Provider Demographics
NPI:1740745793
Name:YAROS, JUSTIN (LMFT)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:YAROS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S SEPULVEDA BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6976
Mailing Address - Country:US
Mailing Address - Phone:424-209-8810
Mailing Address - Fax:
Practice Address - Street 1:500 S SEPULVEDA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6976
Practice Address - Country:US
Practice Address - Phone:424-209-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT92508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist