Healthcare Provider Details

I. General information

NPI: 1013820711
Provider Name (Legal Business Name): JANET ZOEY YANEZ ADCT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11010 PRAIRIE LAKES DR STE 350
EDEN PRAIRIE MN
55344-3801
US

IV. Provider business mailing address

3546 25TH AVE S
MINNEAPOLIS MN
55406-2536
US

V. Phone/Fax

Practice location:
  • Phone: 212-804-6951
  • Fax:
Mailing address:
  • Phone: 763-316-8728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3042
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: