Provider Demographics
NPI:1750867644
Name:YEATER, JANICE JENNIFER (MSCP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:JENNIFER
Last Name:YEATER
Suffix:
Gender:F
Credentials:MSCP
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:JENNIFER
Other - Last Name:CAROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2308 BAYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-7301
Mailing Address - Country:US
Mailing Address - Phone:707-845-6286
Mailing Address - Fax:
Practice Address - Street 1:2308 BAYVIEW LN
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-7301
Practice Address - Country:US
Practice Address - Phone:707-845-6286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty