Healthcare Provider Details

I. General information

NPI: 1437448024
Provider Name (Legal Business Name): YVONNE CIENFUEGOS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YVONNE CIENFUEGOS-MERCADO MSW

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 LONG BEACH BLVD STE 700
LONG BEACH CA
90807-2000
US

IV. Provider business mailing address

4300 LONG BEACH BLVD STE 700
LONG BEACH CA
90807-2000
US

V. Phone/Fax

Practice location:
  • Phone: 310-783-4677
  • Fax: 562-256-7126
Mailing address:
  • Phone: 310-783-4677
  • Fax: 562-256-7126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: