MEDICARE: DR. JOANNA YAHOUDAI PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	24247	CA

General Provider Information

NPI Number	:	1235425315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOANNA YAHOUDAI PSY.D

Provider Business Mailing Address
First Line	:	10390 WILSHIRE BLVD
Second Line	:	1203
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10390 WILSHIRE BLVD
Second Line	:	1203
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6431
Country	:	US
Telephone Number	:	310-435-9550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	10/11/2021

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