Healthcare Provider Details

I. General information

NPI: 1558101626
Provider Name (Legal Business Name): LUSINE YEU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5319 UNIVERSITY DR # 339
IRVINE CA
92612-2965
US

IV. Provider business mailing address

5319 UNIVERSITY DR # 339
IRVINE CA
92612-2965
US

V. Phone/Fax

Practice location:
  • Phone: 949-690-4541
  • Fax:
Mailing address:
  • Phone: 949-690-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT141087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: