MEDICARE: YESENIA ELIZABETH SIGUENZA

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	1041C0700X	Clinical Social Worker	LCSW88234	CA

General Provider Information

NPI Number	:	1568626786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YESENIA ELIZABETH SIGUENZA

Provider Business Mailing Address
First Line	:	PO BOX 971
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-0033
Country	:	US
Telephone Number	:	626-655-1046
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 N BRAND BLVD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1221
Country	:	US
Telephone Number	:	626-655-1046
Fax Number	:

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	11/23/2024

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