Healthcare Provider Details

I. General information

NPI: 1821825894
Provider Name (Legal Business Name): YADIRA COVARRUBIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16124 ROSECRANS AVE APT 5C
LA MIRADA CA
90638-4227
US

IV. Provider business mailing address

16124 ROSECRANS AVE APT 5C
LA MIRADA CA
90638-4227
US

V. Phone/Fax

Practice location:
  • Phone: 714-469-4022
  • Fax:
Mailing address:
  • Phone: 714-469-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: