Provider Demographics
NPI:1114343167
Name:JUAREZ MEZA, YANNETTE
Entity Type:Individual
Prefix:
First Name:YANNETTE
Middle Name:
Last Name:JUAREZ MEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 LOUIE PL
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-4337
Mailing Address - Country:US
Mailing Address - Phone:760-535-9007
Mailing Address - Fax:
Practice Address - Street 1:1030 LOUIE PL
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-4337
Practice Address - Country:US
Practice Address - Phone:760-535-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator