Provider Demographics
NPI:1407313901
Name:FLORES, YOLANDA ESTELLA (PSYCHIATRIC TECHNICI)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:ESTELLA
Last Name:FLORES
Suffix:
Gender:F
Credentials:PSYCHIATRIC TECHNICI
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:ESTELLA
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYCHIATRIC TECHNICI
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-1024
Mailing Address - Country:US
Mailing Address - Phone:707-994-7090
Mailing Address - Fax:707-274-9192
Practice Address - Street 1:7000 S CENTER DR BLDG B
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422-8131
Practice Address - Country:US
Practice Address - Phone:707-994-7090
Practice Address - Fax:707-994-7092
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33859167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician