Provider Demographics
NPI:1205924727
Name:YESCHIN, NATALIE JUDY
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:JUDY
Last Name:YESCHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:JUDY
Other - Last Name:YESCHIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:509 MARIN ST
Mailing Address - Street 2:124-D
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4261
Mailing Address - Country:US
Mailing Address - Phone:805-373-8365
Mailing Address - Fax:805-373-8367
Practice Address - Street 1:509 MARIN ST
Practice Address - Street 2:124-D
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4261
Practice Address - Country:US
Practice Address - Phone:805-373-8365
Practice Address - Fax:805-373-8367
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 204171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADMH 02264OtherLA COUNTY DMH