Healthcare Provider Details

I. General information

NPI: 1437559358
Provider Name (Legal Business Name): YAELLE DERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YAELLE HERSH L.AC.

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13203 GRUNT HILL RD
NEVADA CITY CA
95959-9474
US

IV. Provider business mailing address

13203 GRUNT HILL RD
NEVADA CITY CA
95959-9474
US

V. Phone/Fax

Practice location:
  • Phone: 303-507-1927
  • Fax:
Mailing address:
  • Phone: 303-507-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20397
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU1239
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: