MEDICARE: DR. YAZMINE P HUIZAR 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	103T00000X	Psychologist	40476	TX
2	103T00000X	Psychologist	35517	CA
3	103TB0200X	Cognitive & Behavioral Psychologist	40476	TX
4	103TB0200X	Cognitive & Behavioral Psychologist	35517	CA
5	103TC0700X	Clinical Psychologist	35517	CA
6	103TH0004X	Health Psychologist	40476	TX
7	103TH0004X	Health Psychologist	35517	CA
8	103TH0100X	Health Service Psychologist	40476	TX
9	103TH0100X	Health Service Psychologist	35517	CA
10	103TC0700X	Clinical Psychologist	40476	TX

General Provider Information

NPI Number	:	1558160507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YAZMINE P HUIZAR PH.D.

Provider Business Mailing Address
First Line	:	3237 TOMAHAWK ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2315
Country	:	US
Telephone Number	:	915-637-9736
Fax Number	:

Provider Business Practice Location Address
First Line	:	3237 TOMAHAWK ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2315
Country	:	US
Telephone Number	:	915-637-9736
Fax Number	:

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

Provider Enumeration Date	:	03/12/2025
Last Update Date	:	03/12/2025

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Directions to “ DR. YAZMINE P HUIZAR PH.D.” Practice Location

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