Healthcare Provider Details

I. General information

NPI: 1386245488
Provider Name (Legal Business Name): ELENA A YRIGOLLEN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7658 N SANTA FE AVE
FRESNO CA
93722-2391
US

IV. Provider business mailing address

5325 N FRESNO ST STE 106
FRESNO CA
93710-6849
US

V. Phone/Fax

Practice location:
  • Phone: 559-515-6914
  • Fax:
Mailing address:
  • Phone: 877-418-2977
  • Fax: 866-500-2187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: