MEDICARE: YOLANDA FITCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1346885233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA FITCH

Provider Business Mailing Address
First Line	:	150 SUTTER ST UNIT 120
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-9004
Country	:	US
Telephone Number	:	888-657-4456
Fax Number	:	415-989-5001

Provider Business Practice Location Address
First Line	:	1260 CLEVELAND AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-7326
Country	:	US
Telephone Number	:	888-657-4456
Fax Number	:	415-989-5001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	11/14/2019

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Directions to “ YOLANDA FITCH ” Practice Location

Language	Start Address	Practice Location

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