Healthcare Provider Details

I. General information

NPI: 1164394045
Provider Name (Legal Business Name): CHRISTIAN YANEZ LICENSED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14833 CALPELLA ST
LA MIRADA CA
90638-3004
US

IV. Provider business mailing address

14833 CALPELLA ST
LA MIRADA CA
90638-3004
US

V. Phone/Fax

Practice location:
  • Phone: 562-283-8171
  • Fax:
Mailing address:
  • Phone: 562-283-8171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN JOSHUA YANEZ
Title or Position: CEO/ CLINICAL DIRECTOR
Credential: LCSW
Phone: 562-578-6130