Provider Demographics
NPI:1306357421
Name:LATHERS, YVONNE
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:LATHERS
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 1:6600 BRANN ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2015
Mailing Address - Country:US
Mailing Address - Phone:510-408-6109
Mailing Address - Fax:
Practice Address - Street 1:433 TURK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3329
Practice Address - Country:US
Practice Address - Phone:415-928-7800
Practice Address - Fax:415-928-3710
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)