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General NPI Number Information
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NPI Number | 1164520656
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Entity Type | Organization
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Legal Business Name | JOAN M. YBARRA, PSYD., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/26/2020
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Provider Practice Location Address
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Address Line | 599 S BARRANCA AVE SUITE 221
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City | COVINA
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State | CA
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Zip | 91723-2777
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Country | US
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Telephone | 909-573-7660
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Fax | 626-912-6235
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Provider Business Mailing Address
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Address Line | 599 S BARRANCA AVE SUITE 221
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City | COVINA
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State | CA
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Zip | 91723-2777
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Country | US
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Telephone | 909-573-7660
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Fax | 626-912-6235
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOAN M YBARRA
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Credential |
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Telephone | 909-573-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 16627
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License Number State | CA
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