Healthcare Provider Details

I. General information

NPI: 1972453793
Provider Name (Legal Business Name): THE YARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2026
Last Update Date: 01/31/2026
Certification Date: 01/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 WARNER AVE UNIT 209
HUNTINGTON BEACH CA
92647-7927
US

IV. Provider business mailing address

6600 WARNER AVE UNIT 209
HUNTINGTON BEACH CA
92647-7927
US

V. Phone/Fax

Practice location:
  • Phone: 458-347-1351
  • Fax:
Mailing address:
  • Phone: 458-347-1351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL BRADSHAW JR.
Title or Position: CEO
Credential:
Phone: 458-347-1351