Healthcare Provider Details

I. General information

NPI: 1083566962
Provider Name (Legal Business Name): ELIJAH YOKUM RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41769 ENTERPRISE CIR N STE 101
TEMECULA CA
92590-5626
US

IV. Provider business mailing address

41769 ENTERPRISE CIR N STE 101
TEMECULA CA
92590-5626
US

V. Phone/Fax

Practice location:
  • Phone: 951-719-3738
  • Fax: 951-719-3731
Mailing address:
  • Phone: 951-719-3738
  • Fax: 951-719-3731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-505403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: