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General NPI Number Information
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NPI Number | 1689112229
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Entity Type | Individual
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Provider Name | YAJAIRA JOCELYN URENA
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Gender | Female
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 470 CHADBOURNE RD
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City | FAIRFIELD
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State | CA
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Zip | 94534-9600
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Country | US
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Telephone | 707-419-8989
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Fax | 707-254-1779
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Provider Business Mailing Address
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Address Line | 1141 PEAR TREE LN STE 100
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City | NAPA
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State | CA
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Zip | 94558-6485
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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 | 123841
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License Number State | CA
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