Healthcare Provider Details

I. General information

NPI: 1598652802
Provider Name (Legal Business Name): LORISA YANCY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71175 AURORA RD
DESERT HOT SPRINGS CA
92241-7631
US

IV. Provider business mailing address

52835 AVENIDA RAMIREZ
LA QUINTA CA
92253-5301
US

V. Phone/Fax

Practice location:
  • Phone: 760-251-8858
  • Fax:
Mailing address:
  • Phone: 760-960-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139547
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: