Healthcare Provider Details

I. General information

NPI: 1841855350
Provider Name (Legal Business Name): YANA NEWBERG LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 QUAIL ST STE 210
NEWPORT BEACH CA
92660-2761
US

IV. Provider business mailing address

360 VILLA POINT DR
NEWPORT BEACH CA
92660-6238
US

V. Phone/Fax

Practice location:
  • Phone: 949-784-9553
  • Fax:
Mailing address:
  • Phone: 949-784-9553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: