Provider Demographics
NPI:1316534944
Name:YAUKEY, MARY KATHERINE (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:YAUKEY
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:MARY KATE
Other - Middle Name:
Other - Last Name:YAUKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:921 FLORENCE LN
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4901
Mailing Address - Country:US
Mailing Address - Phone:813-766-1661
Mailing Address - Fax:
Practice Address - Street 1:921 FLORENCE LN
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4901
Practice Address - Country:US
Practice Address - Phone:813-766-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-55046103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst