Provider Demographics
NPI:1841855350
Name:NEWBERG, YANA (LMFT)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:NEWBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 VILLA POINT DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6238
Mailing Address - Country:US
Mailing Address - Phone:949-784-9553
Mailing Address - Fax:
Practice Address - Street 1:1400 QUAIL ST STE 210
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2761
Practice Address - Country:US
Practice Address - Phone:949-784-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100823106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist