Basic Information
Provider Information
NPI: 1013076033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITTINGTON
FirstName: YOLANDA
MiddleName: YVETTE
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 56145
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900560145
CountryCode: US
TelephoneNumber: 2132919039
FaxNumber: 3232910195
Practice Location
Address1: 3756 SANTA ROSALIA DR STE 219
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900083616
CountryCode: US
TelephoneNumber: 2132919039
FaxNumber: 3232910195
Other Information
ProviderEnumerationDate: 12/06/2006
LastUpdateDate: 01/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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