Healthcare Provider Details

I. General information

NPI: 1861953135
Provider Name (Legal Business Name): CHELSEA YULE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N MAIN ST
JACKSON CA
95642
US

IV. Provider business mailing address

PO BOX 964
JACKSON CA
95642-0964
US

V. Phone/Fax

Practice location:
  • Phone: 209-560-0414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA YULE
Title or Position: LCSW
Credential: LCSW
Phone: 209-560-0414