Provider Demographics
NPI:1679180418
Name:YEATES, SHA'ALA LYNN (CHE, CLC, BS)
Entity Type:Individual
Prefix:MS
First Name:SHA'ALA
Middle Name:LYNN
Last Name:YEATES
Suffix:
Gender:F
Credentials:CHE, CLC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DELTA FAIR BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4004
Mailing Address - Country:US
Mailing Address - Phone:925-779-5461
Mailing Address - Fax:925-779-5474
Practice Address - Street 1:3400 DELTA FAIR BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4004
Practice Address - Country:US
Practice Address - Phone:925-779-5461
Practice Address - Fax:925-779-5474
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator