MEDICARE: EMILY YETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8794	OTHER	CA	UBH NUMBER

General Provider Information

NPI Number	:	1508977570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY YETTE

Provider Business Mailing Address
First Line	:	2221 CAMINO DEL RIO S
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3608
Country	:	US
Telephone Number	:	619-993-6392
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 CAMINO DEL RIO S
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3608
Country	:	US
Telephone Number	:	619-993-6392
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ EMILY YETTE ” Practice Location

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