Healthcare Provider Details
I. General information
NPI: 1609697440
Provider Name (Legal Business Name): YURI PAOLA CUBIDES VALERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/23/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1650 S AMPHLETT BLVD
SAN MATEO CA
94402-2517
US
IV. Provider business mailing address
1359 EDGEWOOD RD
EMERALD HILLS CA
94062-2730
US
V. Phone/Fax
- Phone: 650-581-1542
- Fax:
- Phone: 707-710-0266
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TR0400X |
| Taxonomy | Rehabilitation Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: