Healthcare Provider Details

I. General information

NPI: 1730213331
Provider Name (Legal Business Name): YU ENOMOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5632 VAN NUYS BLVD # 585
VAN NUYS CA
91401-4602
US

IV. Provider business mailing address

5632 VAN NUYS BLVD # 585
VAN NUYS CA
91401-4602
US

V. Phone/Fax

Practice location:
  • Phone: 818-570-6933
  • Fax:
Mailing address:
  • Phone: 818-570-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC45072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: