Healthcare Provider Details

I. General information

NPI: 1033587993
Provider Name (Legal Business Name): YUDID FELICITAS OSUNA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E AVENUE I
LANCASTER CA
93535-1916
US

IV. Provider business mailing address

520 W PALMDALE BLVD SUITE D
PALMDALE CA
93551-4229
US

V. Phone/Fax

Practice location:
  • Phone: 661-471-4287
  • Fax:
Mailing address:
  • Phone: 661-575-8395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number88477
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1033587993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: