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NPI Code Detail

MEDICARE: DR. YVONNE ELISABETH BRUINSMA PHD, BCBA-D

MEDICARE: DR. YVONNE ELISABETH BRUINSMA PHD, BCBA-D
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
1103K00000XBehavior Analyst1-08-4278
2103K00000XBehavior Analyst1-08-4278CA

General Provider Information

NPI Number : 1699092585
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YVONNE ELISABETH BRUINSMA PHD, BCBA-D
Provider Business Mailing Address
First Line : 10 BAYVIEW
Second Line :
City : IRVINE
State : CA
Zip : 92614-7989
Country : US
Telephone Number : 949-533-6818
Fax Number : 949-726-8324
Provider Business Practice Location Address
First Line : 3652 MICHELSON DR
Second Line :
City : IRVINE
State : CA
Zip : 92612-1727
Country : US
Telephone Number : 949-533-6818
Fax Number : 949-726-8324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2010
Last Update Date : 11/15/2021

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