Healthcare Provider Details

I. General information

NPI: 1508080284
Provider Name (Legal Business Name): ALEX YAN YUFIK PSY.D., J.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N ROBERTSON BLVD
WEST HOLLYWOOD CA
90048-1732
US

IV. Provider business mailing address

1525 LAUREL ST
SOUTH PASADENA CA
91030-4477
US

V. Phone/Fax

Practice location:
  • Phone: 800-810-5743
  • Fax:
Mailing address:
  • Phone: 626-676-7487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number19520
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number19520
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number19520
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number19520
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number19520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: