Provider Demographics
NPI:1003455247
Name:GUEVARA, YENI PATRICIA (101YA0400X)
Entity Type:Individual
Prefix:MRS
First Name:YENI
Middle Name:PATRICIA
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:101YA0400X
Other - Prefix:
Other - First Name:YENI
Other - Middle Name:PATRICIA
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9033 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3839
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:562-942-9695
Practice Address - Street 1:9033 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3839
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:562-942-9695
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)