Healthcare Provider Details

I. General information

NPI: 1639089741
Provider Name (Legal Business Name): YVETTE YAMBAO-WACHER
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: YVETTE YAMBAO

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 1ST AVE
DALY CITY CA
94014-2698
US

IV. Provider business mailing address

123 EDGEMONT DR
DALY CITY CA
94015-3868
US

V. Phone/Fax

Practice location:
  • Phone: 650-550-7845
  • Fax:
Mailing address:
  • Phone: 650-550-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: