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NPI Code Detail

MEDICARE: YAEL JEZENIA CORREA

MEDICARE: YAEL JEZENIA CORREA
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
1103TC1900XCounseling PsychologistCA
2225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1780190652
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAEL JEZENIA CORREA
Provider Business Mailing Address
First Line : 1333 WILLOW PASS RD STE 102
Second Line :
City : CONCORD
State : CA
Zip : 94520-5225
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3095 RICHMOND PKWY STE 201
Second Line :
City : RICHMOND
State : CA
Zip : 94806-5878
Country : US
Telephone Number : 510-778-2816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2017
Last Update Date : 04/15/2026

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Directions to “ YAEL JEZENIA CORREA ” Practice Location

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