MEDICARE: YORAM JAFFE PH 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	PSY8237	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497853642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YORAM JAFFE PH D

Provider Business Mailing Address
First Line	:	1401 COMSTOCK AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-5316
Country	:	US
Telephone Number	:	310-277-4080
Fax Number	:	310-277-4080

Provider Business Practice Location Address
First Line	:	16661 VENTURA BLVD
Second Line	:	SUITE 603
City	:	ENCINO
State	:	CA
Zip	:	91436-4829
Country	:	US
Telephone Number	:	310-277-4080
Fax Number	:	310-277-4080

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/31/2026

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