Healthcare Provider Details

I. General information

NPI: 1972276251
Provider Name (Legal Business Name): YELENA TOKMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2021
Last Update Date: 07/31/2021
Certification Date: 07/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S ROBERTSON BLVD STE 305
LOS ANGELES CA
90035-1632
US

IV. Provider business mailing address

3880 FREDONIA DR APT F
LOS ANGELES CA
90068-1247
US

V. Phone/Fax

Practice location:
  • Phone: 310-289-3370
  • Fax:
Mailing address:
  • Phone: 323-459-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT122300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: