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General NPI Number Information
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NPI Number | 1679630644
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Entity Type | Individual
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Provider Name | JEANNE PATRICIA YETZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 517 N HORNE ST
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City | OCEANSIDE
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State | CA
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Zip | 92054-2518
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Country | US
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Telephone | 760-631-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 VALE TERRACE DR
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City | VISTA
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State | CA
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Zip | 92084-5218
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 61458
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35974
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G143220
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License Number State | CA
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