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General NPI Number Information
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NPI Number | 1578378949
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Entity Type | Individual
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Provider Name | YARITZA SIQUEIROS
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 114 W HALL AVE
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City | SAN YSIDRO
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State | CA
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Zip | 92173-2693
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Country | US
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Telephone | 619-420-3620
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Fax |
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Provider Business Mailing Address
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Address Line | 430 F ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-3711
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Country | US
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Telephone |
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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 | 128781
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License Number State | CA
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