Healthcare Provider Details

I. General information

NPI: 1467874479
Provider Name (Legal Business Name): DOROTHY K YUNGMAN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W 213TH ST SUITE 100
TORRANCE CA
90501-2800
US

IV. Provider business mailing address

1602 5TH ST
MANHATTAN BEACH CA
90266-6342
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-0276
  • Fax:
Mailing address:
  • Phone: 310-892-2788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: