MEDICARE: YASI NIA

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	103T00000X	Psychologist	94029325	CA

General Provider Information

NPI Number	:	1245184142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASI NIA

Provider Business Mailing Address
First Line	:	6320 TOPANGA CANYON BLVD STE 1630
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-2299
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE STE 204
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5385
Country	:	US
Telephone Number	:	310-902-0990
Fax Number	:

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

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ YASI NIA ” Practice Location

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