Healthcare Provider Details

I. General information

NPI: 1255266219
Provider Name (Legal Business Name): YASMIN IRELY HERRERA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14611 W CENTER RD
OMAHA NE
68144-3219
US

IV. Provider business mailing address

6716 S 31ST ST
OMAHA NE
68107-4021
US

V. Phone/Fax

Practice location:
  • Phone: 402-807-7447
  • Fax:
Mailing address:
  • Phone: 531-210-8207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: