Healthcare Provider Details

I. General information

NPI: 1669301586
Provider Name (Legal Business Name): KATHLEEN YESNICK ADAMS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 MALAGA COVE PLZ STE 203
PALOS VERDES ESTATES CA
90274-6813
US

IV. Provider business mailing address

36 MALAGA COVE PLZ STE 203
PALOS VERDES ESTATES CA
90274-6813
US

V. Phone/Fax

Practice location:
  • Phone: 310-951-6621
  • Fax: 310-951-6621
Mailing address:
  • Phone: 310-951-6621
  • Fax: 310-951-6621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039943
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number770834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: