Provider Demographics
NPI:1184827131
Name:YANEZ, ROSALINDA (MS MFCC MFT)
Entity Type:Individual
Prefix:MS
First Name:ROSALINDA
Middle Name:
Last Name:YANEZ
Suffix:
Gender:F
Credentials:MS MFCC MFT
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:YANEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS MFCC MFT
Mailing Address - Street 1:2154 CHANDLER
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-4611
Mailing Address - Country:US
Mailing Address - Phone:805-208-9214
Mailing Address - Fax:805-482-5366
Practice Address - Street 1:484 MOBIL AVE
Practice Address - Street 2:STE 13
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-208-9214
Practice Address - Fax:805-482-5366
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT MFC 39953106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist