Provider Demographics
NPI:1639996713
Name:KINDZIAYEVA, YULIYA (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:KINDZIAYEVA
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:YULIA
Other - Middle Name:
Other - Last Name:KINDZIAYEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AMFT, APCC
Mailing Address - Street 1:2111 CORONET BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-1618
Mailing Address - Country:US
Mailing Address - Phone:415-305-5140
Mailing Address - Fax:
Practice Address - Street 1:2111 CORONET BLVD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-1618
Practice Address - Country:US
Practice Address - Phone:415-305-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT147940106H00000X
CAAPCC17142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health