Provider Demographics
NPI:1326162652
Name:PORTERFIELD, YVONNE T (CNS)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:T
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2304
Mailing Address - Country:US
Mailing Address - Phone:510-891-3859
Mailing Address - Fax:
Practice Address - Street 1:2000 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2304
Practice Address - Country:US
Practice Address - Phone:510-891-3859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS 1235364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult