Provider Demographics
NPI:1740642990
Name:HEMMAT, YASAMAN JOAN (MD)
Entity type:Individual
Prefix:
First Name:YASAMAN
Middle Name:JOAN
Last Name:HEMMAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:320 GOLD AVE SW STE 1001
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3228
Mailing Address - Country:US
Mailing Address - Phone:505-247-4900
Mailing Address - Fax:505-933-6373
Practice Address - Street 1:320 GOLD AVE SW STE 1001
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3228
Practice Address - Country:US
Practice Address - Phone:505-247-4900
Practice Address - Fax:505-933-6373
Is Sole Proprietor?:No
Enumeration Date:2016-03-27
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3101172084P0800X
NMMD2021-04662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry