Healthcare Provider Details

I. General information

NPI: 1245062090
Provider Name (Legal Business Name): HEALTHCARE PROFESSIONALS MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14405 FOOLISH PLEASURE RD
BOYDS MD
20841-6014
US

IV. Provider business mailing address

489 SANCHEZ ST
SAN FRANCISCO CA
94114-2056
US

V. Phone/Fax

Practice location:
  • Phone: 252-695-5297
  • Fax:
Mailing address:
  • Phone: 847-650-1778
  • Fax: 415-358-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE YOESEP
Title or Position: COO
Credential:
Phone: 847-650-1778