Kimberly Stephany Yantuche-Hernandez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110128 Issued in CA

Practice address

2620 Industry Way Ste C
Lynwood, CA 90262-4042

Phone

(310) 894-1663

NPI assigned

Jun 12, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1326177379
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1942869904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 INDUSTRY WAY STE C",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624042",
            "telephone_number": "310-894-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 INDUSTRY WAY STE C",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624042",
            "telephone_number": "310-894-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2620 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624024",
            "country_code": "US",
            "telephone_number": "310-667-4070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624284",
            "country_code": "US",
            "telephone_number": "310-627-4525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANTUCHE-HERNANDEZ",
        "first_name": "KIMBERLY",
        "middle_name": "STEPHANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW90190",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodlawn Park, Inc
• Erin Work
• Sarah Yabroff, SLP-CCC
• Anton Yanagisawa
• Sita L Yanamadala, M.D.
• Jee Ryang Yoo, DDS
• Jonathan Chung Yoo
• Joo Yoo
• Seong Hee Yoo
• Harding G Young, MD

• All providers in Lynwood, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.