Provider Demographics
NPI:1477261634
Name:YZAGUIRRE, CECEILIA
Entity Type:Individual
Prefix:MS
First Name:CECEILIA
Middle Name:
Last Name:YZAGUIRRE
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 1:2201 ZEUS CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6867
Mailing Address - Country:US
Mailing Address - Phone:888-831-7977
Mailing Address - Fax:888-831-0909
Practice Address - Street 1:2201 ZEUS CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6867
Practice Address - Country:US
Practice Address - Phone:888-831-7977
Practice Address - Fax:888-831-0909
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56242247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA270266167Medicaid