Provider Demographics
NPI:1932487519
Name:YEGANEGI, FERIAL YASMINE (MFT)
Entity Type:Individual
Prefix:
First Name:FERIAL
Middle Name:YASMINE
Last Name:YEGANEGI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 LAKE MCCLURE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2473
Mailing Address - Country:US
Mailing Address - Phone:408-717-1812
Mailing Address - Fax:
Practice Address - Street 1:1625 THE ALAMEDA STE 207
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2223
Practice Address - Country:US
Practice Address - Phone:408-236-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40388106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist