Healthcare Provider Details

I. General information

NPI: 1124950167
Provider Name (Legal Business Name): YEVA FARR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YEVA SWANNER CCC-SLP

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E PARK ST
STOCKTON CA
95202-2207
US

IV. Provider business mailing address

701 E PARK ST
STOCKTON CA
95202-2207
US

V. Phone/Fax

Practice location:
  • Phone: 209-933-7496
  • Fax:
Mailing address:
  • Phone: 209-933-7496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP24349
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: