Healthcare Provider Details

I. General information

NPI: 1891883906
Provider Name (Legal Business Name): YULEEN YURI AL-SAOUDI M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 W SHAW AVE
CLOVIS CA
93612-3211
US

IV. Provider business mailing address

686 W SHAW AVE
CLOVIS CA
93612-3211
US

V. Phone/Fax

Practice location:
  • Phone: 559-824-8496
  • Fax:
Mailing address:
  • Phone: 559-824-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT39300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: