MEDICARE: KATHERINE GRACE YODER

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	2084P0804X	Child & Adolescent Psychiatry Physician	20A24109	CA
2	2084P0804X	Child & Adolescent Psychiatry Physician	24109	CA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1619619756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE GRACE YODER

Provider Business Mailing Address
First Line	:	823 GATEWAY CENTER WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-4541
Country	:	US
Telephone Number	:	619-515-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 CHILDRENS WAY # 5018
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-966-7759
Fax Number	:

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

Provider Enumeration Date	:	04/09/2022
Last Update Date	:	04/06/2026

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1134060874 — EMILIE LORRAINE FISHER-GUPTA MD, PHD
Practice Location Address:

3020 CHILDRENS WAY
SAN DIEGO, CA
92123-4223

Practice Phone: 858-966-6764
Practice Fax:

1780526079 — CORINNE MCCARTHY
Practice Location Address:

3020 CHILDRENS WAY
SAN DIEGO, CA
92123-4223

Practice Phone: 858-575-1700
Practice Fax:

1477494177 — MYRKA PAOLA MACEDO MD
Practice Location Address:

3020 CHILDRENS WAY
SAN DIEGO, CA
92123-4223

Practice Phone: 858-966-6764
Practice Fax: 858-966-7966

1225036627 — RAYMOND R FRIPP MD
Practice Location Address:

3020 CHILDRENS WAY
SAN DIEGO, CA
92123-4223

Practice Phone: 858-966-5855
Practice Fax:

1144221763 — DR. KAMEI TOLBA M.D.
Practice Location Address:

3020 CHILDRENS WAY , MC 5075
SAN DIEGO, CA
92123-4223

Practice Phone: 858-966-8036
Practice Fax:

Directions to “ KATHERINE GRACE YODER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.