Healthcare Provider Details

I. General information

NPI: 1588159396
Provider Name (Legal Business Name): KHAI LYEE YEAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8616 LA TIJERA BLVD STE 200
LOS ANGELES CA
90045-3945
US

IV. Provider business mailing address

3314 SUMMERTIME LN
CULVER CITY CA
90230-4595
US

V. Phone/Fax

Practice location:
  • Phone: 408-368-9073
  • Fax:
Mailing address:
  • Phone: 408-368-9073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: