Provider Demographics
NPI:1508539230
Name:BARAHONA, YAHAIRA SARAHI
Entity Type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:SARAHI
Last Name:BARAHONA
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 1:15201 PAIGE AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-7670
Mailing Address - Country:US
Mailing Address - Phone:951-275-3615
Mailing Address - Fax:
Practice Address - Street 1:15201 PAIGE AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551-7670
Practice Address - Country:US
Practice Address - Phone:951-275-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty