Provider Demographics
NPI:1326546383
Name:COOK, YVETTE PRINGLE
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:PRINGLE
Last Name:COOK
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 1:1400 N NORMA ST
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-2575
Mailing Address - Country:US
Mailing Address - Phone:760-499-7406
Mailing Address - Fax:
Practice Address - Street 1:1400 N NORMA ST
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555
Practice Address - Country:US
Practice Address - Phone:760-499-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$OtherSUBSTANCE ABUSE COUNSELING