Provider Demographics
NPI:1164994182
Name:SALDIVAR, YVONNE A
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:A
Last Name:SALDIVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:ANTOINETTE
Other - Last Name:SALDIVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8622 S ZARZAMORA ST LOT 274
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-2046
Mailing Address - Country:US
Mailing Address - Phone:210-343-0334
Mailing Address - Fax:
Practice Address - Street 1:8622 S ZARZAMORA ST LOT 274
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-2046
Practice Address - Country:US
Practice Address - Phone:210-343-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15-09729106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty