Healthcare Provider Details

I. General information

NPI: 1457911968
Provider Name (Legal Business Name): YVONNE ANNETTE SUYAT CADTPII ,MHACBOI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVONNE ANNETTE TATE CADTPII ,MHACBOI

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 HARTNELL AVE
REDDING CA
96002-2113
US

IV. Provider business mailing address

6153 VERDE VALE CT
ANDERSON CA
96007-4831
US

V. Phone/Fax

Practice location:
  • Phone: 530-222-7213
  • Fax: 530-222-7268
Mailing address:
  • Phone: 530-354-0954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: