Provider Demographics
NPI:1760531248
Name:YEW, AMOS (PSYD)
Entity Type:Individual
Prefix:
First Name:AMOS
Middle Name:
Last Name:YEW
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 YARBERRY DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-6800
Mailing Address - Country:US
Mailing Address - Phone:707-765-1080
Mailing Address - Fax:
Practice Address - Street 1:3900 LAKEVILLE HWY
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-5698
Practice Address - Country:US
Practice Address - Phone:707-765-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19423103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical