Healthcare Provider Details

I. General information

NPI: 1881105195
Provider Name (Legal Business Name): ANESCIA YVETTE BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12968 FREDERICK ST STE A
MORENO VALLEY CA
92553-5229
US

IV. Provider business mailing address

12968 FREDERICK ST STE A
MORENO VALLEY CA
92553-5229
US

V. Phone/Fax

Practice location:
  • Phone: 951-242-7738
  • Fax: 951-242-7733
Mailing address:
  • Phone: 951-242-7738
  • Fax: 951-242-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT152582
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110942
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: