Healthcare Provider Details

I. General information

NPI: 1417004649
Provider Name (Legal Business Name): LARRY YAVORSKY RN, MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

IV. Provider business mailing address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

V. Phone/Fax

Practice location:
  • Phone: 415-352-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC34449
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number321825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: