Provider Demographics
NPI:1700069507
Name:YAHR, BEVERLY (PHD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:YAHR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78361 GRAPE ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-1372
Mailing Address - Country:US
Mailing Address - Phone:760-200-4410
Mailing Address - Fax:760-200-4410
Practice Address - Street 1:78361 GRAPE ARBOR AVE
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-1372
Practice Address - Country:US
Practice Address - Phone:760-200-4410
Practice Address - Fax:760-200-4410
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2011-03-03
Deactivation Date:2010-11-02
Deactivation Code:
Reactivation Date:2011-03-03
Provider Licenses
StateLicense IDTaxonomies
CAPSY12201103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical