Provider Demographics
NPI:1669342713
Name:YEBOAH MARRIAGE & FAMILY THERAPY, INC
Entity type:Organization
Organization Name:YEBOAH MARRIAGE & FAMILY THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:YOUNG-YEBOAH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-352-4912
Mailing Address - Street 1:1630 W REDLANDS BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8032
Mailing Address - Country:US
Mailing Address - Phone:909-352-4912
Mailing Address - Fax:
Practice Address - Street 1:1630 W REDLANDS BLVD STE J
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8032
Practice Address - Country:US
Practice Address - Phone:909-352-4912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)