MEDICARE: YOCHEVED SARA GABAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	APCC17852	CA
2	106H00000X	Marriage & Family Therapist	AMFT151691	CA

General Provider Information

NPI Number	:	1053128496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOCHEVED SARA GABAY

Provider Business Mailing Address
First Line	:	12413 HARTSOOK ST
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3051
Country	:	US
Telephone Number	:	323-617-2198
Fax Number	:

Provider Business Practice Location Address
First Line	:	12553 KILLION ST
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-1533
Country	:	US
Telephone Number	:	323-617-2198
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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