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General NPI Number Information
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NPI Number | 1780480673
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Entity Type | Organization
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Legal Business Name | SUELEN YANCOR LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 10401 ENGER ST
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2726
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Country | US
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Telephone | 818-213-1045
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Fax |
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Provider Business Mailing Address
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Address Line | 6104 SEPULVEDA BLVD # 1001
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City | VAN NUYS
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State | CA
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Zip | 91411-2503
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Country | US
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Telephone | 818-213-1045
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | SUELEN D YANCOR
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Credential | LCSW
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Telephone | 310-341-6258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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