Healthcare Provider Details

I. General information

NPI: 1063621811
Provider Name (Legal Business Name): SUELEN D. YANCOR M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 ENGER ST
BAKERSFIELD CA
93312-2726
US

IV. Provider business mailing address

13061 ROSEDALE HWY STE G-502
BAKERSFIELD CA
93314-7612
US

V. Phone/Fax

Practice location:
  • Phone: 818-213-1045
  • Fax:
Mailing address:
  • Phone: 818-213-1045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118593
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number75646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: