Yahayra Fuentes
Individual provider Active NPI Behavior Technician · Lakeside, CA
NPI 1992260343 · NPPES record last updated Feb 8, 2019
Key facts
- NPI
- 1992260343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 12720 Laurel St Unit 207
Lakeside, CA 92040-2115 - Phone
- (619) 917-0509
- NPI assigned
- Feb 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
12720 Laurel St Unit 207
Lakeside, CA 92040-2115
Mailing address
12720 Laurel St Unit 207
Lakeside, CA 92040-2115
Phone (619) 917-0509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AJC908819445 | Other | CA | BLUE SHIELD HEALTH PLAN |
Other providers in Lakeside, CA
- Frank B Flint MD Medical Corp
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Center
- Fred Finch Youth Centers
- Zackary Cusati Fulks
- Kathy Gamboa II
- Natalie Garcia Wood
- Erika Garcia
- GHC of Lakeside, LLC
All providers in Lakeside, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.