Provider Demographics
NPI:1689155269
Name:HALCROMB, YASMIN SCOTT
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:SCOTT
Last Name:HALCROMB
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30141 ANTELOPE RD STE D669
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7001
Mailing Address - Country:US
Mailing Address - Phone:323-216-5181
Mailing Address - Fax:
Practice Address - Street 1:4405 RIVERSIDE DR, BURBANK
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:323-213-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85510101YM0800X
1041C0700X
CA1240591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health