Provider Demographics
NPI:1518510684
Name:PENDAS SALGADO, YELENA
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:PENDAS SALGADO
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 1:9410 W FLAGLER ST APT 312
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2042
Mailing Address - Country:US
Mailing Address - Phone:786-641-9229
Mailing Address - Fax:
Practice Address - Street 1:6801 NW 77TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2842
Practice Address - Country:US
Practice Address - Phone:786-641-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-21-11800106E00000X
106S00000X
FL1-21-53180103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician