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General NPI Number Information
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NPI Number | 1790287217
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Entity Type | Individual
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Provider Name | DANIEL YIM MA
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Gender | Male
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 7080 HOLLYWOOD BLVD STE 815
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City | LOS ANGELES
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State | CA
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Zip | 90028-6935
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Country | US
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Telephone | 323-522-9556
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Fax |
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Provider Business Mailing Address
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Address Line | 350 N GLENDALE AVE STE B-151
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City | GLENDALE
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State | CA
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Zip | 91206-3794
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFTI103612
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 103612
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 124084
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License Number State | CA
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