Healthcare Provider Details

I. General information

NPI: 1861850844
Provider Name (Legal Business Name): MISS YVETTE CUADROS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N IRWIN ST
HANFORD CA
93230-3814
US

IV. Provider business mailing address

700 N IRWIN ST
HANFORD CA
93230-3814
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-9300
  • Fax: 559-583-9307
Mailing address:
  • Phone: 559-583-9300
  • Fax: 559-583-9307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number77-0560598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: