Provider Demographics
NPI:1902920358
Name:YAFFE, JAN G (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:G
Last Name:YAFFE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CAMINO DEL MAR
Mailing Address - Street 2:#234
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2640
Mailing Address - Country:US
Mailing Address - Phone:858-205-5269
Mailing Address - Fax:858-534-4403
Practice Address - Street 1:1011 CAMINO DEL MAR
Practice Address - Street 2:#234
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2640
Practice Address - Country:US
Practice Address - Phone:858-205-5269
Practice Address - Fax:858-534-4403
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist