Provider Demographics
NPI:1710641626
Name:CERRITOS, YOBANNY
Entity Type:Individual
Prefix:
First Name:YOBANNY
Middle Name:
Last Name:CERRITOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 JOSEPHINE ST APT C
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-1648
Mailing Address - Country:US
Mailing Address - Phone:831-594-6201
Mailing Address - Fax:
Practice Address - Street 1:785 JOSEPHINE ST APT C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-1648
Practice Address - Country:US
Practice Address - Phone:831-594-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician