Healthcare Provider Details

I. General information

NPI: 1386804870
Provider Name (Legal Business Name): YASMIN DARA JILLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 WESTWOOD DR
SEDALIA MO
65301-2102
US

IV. Provider business mailing address

305 W MAIN ST
SEDALIA MO
65301-3821
US

V. Phone/Fax

Practice location:
  • Phone: 660-826-4774
  • Fax: 660-826-1300
Mailing address:
  • Phone: 660-310-0909
  • Fax: 888-979-8868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101246593
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2015008945
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2015008945
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101246593
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: