Healthcare Provider Details

I. General information

NPI: 1982431086
Provider Name (Legal Business Name): YOLANDA M GURROLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2024
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 W HENDERSON AVE SUITE # 2
PORTERVILLE CA
93257-1490
US

IV. Provider business mailing address

1055 W HENDERSON AVE STE 2
PORTERVILLE CA
93257-1490
US

V. Phone/Fax

Practice location:
  • Phone: 559-788-1200
  • Fax: 559-749-9772
Mailing address:
  • Phone: 559-788-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: