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General NPI Number Information
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NPI Number | 1124171186
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Entity Type | Individual
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Provider Name | MS. PATRICIA SUE YARDLEY
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Gender | Female
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 7 4TH ST STE 62
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City | PETALUMA
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State | CA
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Zip | 94952-7410
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Country | US
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Telephone | 503-853-6847
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 554
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City | PENNGROVE
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State | CA
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Zip | 94951-0554
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Country | US
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Telephone | 503-853-6847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003299
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS18125
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License Number State | CA
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