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NPI Code Detail

MEDICARE: JACQUELINE YAEL AMIN

MEDICARE: JACQUELINE YAEL AMIN
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1285270256
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE YAEL AMIN
Provider Business Mailing Address
First Line : 12501 CHANDLER BLVD STE 102
Second Line :
City : VALLEY VILLAGE
State : CA
Zip : 91607-1955
Country : US
Telephone Number : 818-821-6012
Fax Number :
Provider Business Practice Location Address
First Line : 12501 CHANDLER BLVD STE 102
Second Line :
City : VALLEY VILLAGE
State : CA
Zip : 91607-1955
Country : US
Telephone Number : 818-821-6012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 12/22/2021

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Directions to “ JACQUELINE YAEL AMIN ” Practice Location

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