Healthcare Provider Details

I. General information

NPI: 1376480574
Provider Name (Legal Business Name): CATALINA FERNANDA YANEZ PAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 PAMELA DR
CHINO CA
91710-3062
US

IV. Provider business mailing address

706 N DIAMOND BAR BLVD STE B
DIAMOND BAR CA
91765-1059
US

V. Phone/Fax

Practice location:
  • Phone: 909-591-2653
  • Fax:
Mailing address:
  • Phone: 909-396-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: