Healthcare Provider Details

I. General information

NPI: 1366267510
Provider Name (Legal Business Name): VICTORIA YAMASAKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 CHESTNUT ST STE 402
PHILADELPHIA PA
19106-3060
US

IV. Provider business mailing address

223 BLOOMINGDALE AVE APT J
WAYNE PA
19087-4033
US

V. Phone/Fax

Practice location:
  • Phone: 215-847-6749
  • Fax:
Mailing address:
  • Phone: 240-463-8626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: