MEDICARE: YVETTE BARNES

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	103K00000X	Behavior Analyst		CA

General Provider Information

NPI Number	:	1891327276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE BARNES

Provider Business Mailing Address
First Line	:	6130 W FLAMINGO RD # 632
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2280
Country	:	US
Telephone Number	:	702-405-7945
Fax Number	:

Provider Business Practice Location Address
First Line	:	6769 W CHARLESTON BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-9005
Country	:	US
Telephone Number	:	619-261-3568
Fax Number	:

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

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/05/2020

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Directions to “ YVETTE BARNES ” Practice Location

Language	Start Address	Practice Location

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