Healthcare Provider Details

I. General information

NPI: 1710814660
Provider Name (Legal Business Name): VITALINK MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7977 PRAIRIE ROSE WAY
HIGHLAND CA
92346-5772
US

IV. Provider business mailing address

7977 PRAIRIE ROSE WAY
HIGHLAND CA
92346-5772
US

V. Phone/Fax

Practice location:
  • Phone: 909-841-8346
  • Fax:
Mailing address:
  • Phone: 909-841-8346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LUCY YANEZ
Title or Position: PRESIDENT
Credential:
Phone: 909-841-8346