Provider Demographics
NPI:1720018112
Name:HOBBS, YOLANDA LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:LYNNE
Last Name:HOBBS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13419 W GABLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-2524
Mailing Address - Country:US
Mailing Address - Phone:573-855-7724
Mailing Address - Fax:
Practice Address - Street 1:13419 W GABLE HILL DR
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-2524
Practice Address - Country:US
Practice Address - Phone:573-588-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494980014Medicaid