MEDICARE: PHILLIP YUROVSKY PSY.D.

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	103TC0700X	Clinical Psychologist	PSY28393	CA

General Provider Information

NPI Number	:	1114208865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP YUROVSKY PSY.D.

Provider Business Mailing Address
First Line	:	395 DEL MONTE CTR # 204
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-6156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 DEL MONTE CTR # 204
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-6156
Country	:	US
Telephone Number	:	831-272-4141
Fax Number	:

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

Provider Enumeration Date	:	09/07/2011
Last Update Date	:	10/09/2018

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