Provider Demographics
NPI:1073499968
Name:BURDICK-YAHYA, NAJWA (LEP #4666)
Entity type:Individual
Prefix:
First Name:NAJWA
Middle Name:
Last Name:BURDICK-YAHYA
Suffix:
Gender:F
Credentials:LEP #4666
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 ST LOUIS WAY
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-5572
Mailing Address - Country:US
Mailing Address - Phone:951-801-0513
Mailing Address - Fax:
Practice Address - Street 1:1280 SANTA ANITA CT STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-6128
Practice Address - Country:US
Practice Address - Phone:951-801-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4666103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool