Provider Demographics
NPI:1619039484
Name:MAXWELL, YVONNE RENE (LCSW)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:RENE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1898 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1733
Mailing Address - Country:US
Mailing Address - Phone:408-928-1700
Mailing Address - Fax:408-928-1701
Practice Address - Street 1:1898 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1733
Practice Address - Country:US
Practice Address - Phone:408-928-1700
Practice Address - Fax:408-928-1701
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS160181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical