Healthcare Provider Details

I. General information

NPI: 1124958707
Provider Name (Legal Business Name): YATZI A PAULA B.S, A.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 ELECTRA AVE
SIMI VALLEY CA
93065-1717
US

IV. Provider business mailing address

2135 ELECTRA AVE
SIMI VALLEY CA
93065-1717
US

V. Phone/Fax

Practice location:
  • Phone: 805-317-3779
  • Fax:
Mailing address:
  • Phone: 805-317-3779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: