Provider Demographics
NPI:1023027497
Name:HERRERA, YOLANDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 W TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5070
Mailing Address - Country:US
Mailing Address - Phone:956-994-3880
Mailing Address - Fax:956-994-3877
Practice Address - Street 1:2529 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5070
Practice Address - Country:US
Practice Address - Phone:956-994-3880
Practice Address - Fax:956-994-3877
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18395101YP2500X
TX37552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163081602Medicaid
TX163081603Medicaid