Provider Demographics
NPI:1740320738
Name:YONTEF, GARY M (PHD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:M
Last Name:YONTEF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 7TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2632
Mailing Address - Country:US
Mailing Address - Phone:310-393-6655
Mailing Address - Fax:310-287-1332
Practice Address - Street 1:1460 7TH ST STE 301
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2632
Practice Address - Country:US
Practice Address - Phone:310-393-6655
Practice Address - Fax:310-287-1332
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 3715103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical