Provider Demographics
NPI:1689453763
Name:MEADE, YVONNE MARIE (CLINICAL MSW)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:MARIE
Last Name:MEADE
Suffix:
Gender:F
Credentials:CLINICAL MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W SANTA ANA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4558
Mailing Address - Country:US
Mailing Address - Phone:714-953-4455
Mailing Address - Fax:714-542-2793
Practice Address - Street 1:600 W SANTA ANA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4558
Practice Address - Country:US
Practice Address - Phone:714-953-4455
Practice Address - Fax:714-542-2793
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker