Provider Demographics
NPI:1992589022
Name:ABBOTT, YUKO (LCSW DSW)
Entity type:Individual
Prefix:
First Name:YUKO
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:LCSW DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 JAMACHA RD STE 502-108
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-6313
Mailing Address - Country:US
Mailing Address - Phone:619-248-3238
Mailing Address - Fax:
Practice Address - Street 1:3960 HEALTH SCIENCES DRIVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92093
Practice Address - Country:US
Practice Address - Phone:619-248-3238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical