Healthcare Provider Details

I. General information

NPI: 1124467089
Provider Name (Legal Business Name): MRS. YOLANDA PULIDO-LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 53RD ST
OAKLAND CA
94609-1814
US

IV. Provider business mailing address

3612 SKYLINE DR
HAYWARD CA
94542-2521
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax:
Mailing address:
  • Phone: 510-886-3539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW103809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: