Provider Demographics
NPI:1164394045
Name:CHRISTIAN YANEZ LICENSED CLINICAL SOCIAL WORKER PC
Entity type:Organization
Organization Name:CHRISTIAN YANEZ LICENSED CLINICAL SOCIAL WORKER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:YANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:562-578-6130
Mailing Address - Street 1:14833 CALPELLA ST
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-3004
Mailing Address - Country:US
Mailing Address - Phone:562-283-8171
Mailing Address - Fax:
Practice Address - Street 1:14833 CALPELLA ST
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-3004
Practice Address - Country:US
Practice Address - Phone:562-283-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty