MEDICARE: DAVID YATES MFT

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	106H00000X	Marriage & Family Therapist	MFC16705	CA

General Provider Information

NPI Number	:	1477630788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID YATES MFT

Provider Business Mailing Address
First Line	:	PO BOX 1561
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-1561
Country	:	US
Telephone Number	:	530-676-0223
Fax Number	:	530-622-2793

Provider Business Practice Location Address
First Line	:	3343 EASTVIEW DR
Second Line	:
City	:	SHINGLE SPRINGS
State	:	CA
Zip	:	95682-9531
Country	:	US
Telephone Number	:	530-676-0223
Fax Number	:	530-622-2793

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID YATES MFT” Practice Location

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