Healthcare Provider Details

I. General information

NPI: 1669007571
Provider Name (Legal Business Name): YAQUELIN BALDERAS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 KERN RD
YAKIMA WA
98902-6340
US

IV. Provider business mailing address

171 HOME ACRES RD
WAPATO WA
98951-8702
US

V. Phone/Fax

Practice location:
  • Phone: 509-574-3292
  • Fax:
Mailing address:
  • Phone: 509-731-9395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: