Provider Demographics
NPI:1003235805
Name:ANNA YATSENKO PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:ANNA YATSENKO PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:HANDS OF HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YATSENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-524-6566
Mailing Address - Street 1:11850 HESPERIA RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-2173
Mailing Address - Country:US
Mailing Address - Phone:760-995-4500
Mailing Address - Fax:760-995-4501
Practice Address - Street 1:11850 HESPERIA RD
Practice Address - Street 2:SUITE 11
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-2173
Practice Address - Country:US
Practice Address - Phone:760-995-4500
Practice Address - Fax:760-995-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty