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General NPI Number Information
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NPI Number | 1477098747
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Entity Type | Individual
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Provider Name | YOLANDA CORTES
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Gender | Female
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 923 S CATALINA AVE
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City | REDONDO BEACH
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State | CA
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Zip | 90277
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Country | US
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Telephone | 424-777-5017
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Fax | 310-792-5463
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Provider Business Mailing Address
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Address Line | 2409 OCEANVIEW TER
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City | SAN PEDRO
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State | CA
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Zip | 90731-6398
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Country | US
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Telephone | 424-777-5017
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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