Provider Demographics
NPI: | 1356644223 |
---|---|
Name: | OROPEZA-DIAZ, YASHIRA (PSYD, LMHC, MA-PGS) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | YASHIRA |
Middle Name: | |
Last Name: | OROPEZA-DIAZ |
Suffix: | |
Gender: | F |
Credentials: | PSYD, LMHC, MA-PGS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 280 CHESTNUT STREET |
Mailing Address - Street 2: | 2ND FLOOR |
Mailing Address - City: | SPRINGFIELD |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01199-1001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 413-794-5700 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 300 CAREW STREET |
Practice Address - Street 2: | STE 2 |
Practice Address - City: | SPRINGFIELD |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01104-2146 |
Practice Address - Country: | US |
Practice Address - Phone: | 413-794-9816 |
Practice Address - Fax: | 413-794-4945 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2010-12-14 |
Last Update Date: | 2019-04-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | 8389 | 101YM0800X |
MA | 9911 | 103T00000X, 103TC0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist |