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NPI Code Detail

MEDICARE: YESENIA CORTEZ

MEDICARE: YESENIA CORTEZ
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2172V00000XCommunity Health Worker
3373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1750409462
Entity Type Code : Individual
Provider Name (Legal Business Name) : YESENIA CORTEZ
Provider Business Mailing Address
First Line : 309 B ST
Second Line :
City : WATERFORD
State : CA
Zip : 95386-8773
Country : US
Telephone Number : 209-204-4248
Fax Number :
Provider Business Practice Location Address
First Line : 4545 GEORGETOWN PL STE A3
Second Line :
City : STOCKTON
State : CA
Zip : 95207-6228
Country : US
Telephone Number : 209-541-7399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 04/03/2025

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Directions to “ YESENIA CORTEZ ” Practice Location

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