MEDICARE: JENNIFER YATES MFT

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	106H00000X	Marriage & Family Therapist	MFC43968	CA

General Provider Information

NPI Number	:	1871624676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER YATES MFT

Provider Business Mailing Address
First Line	:	3020 OLD RANCH PKWY
Second Line	:	SUITE 300
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-5559
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 OLD RANCH PKWY
Second Line	:	SUITE 300
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-5559
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	04/08/2015

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