Provider Demographics
NPI:1922027465
Name:BARRAZA-REYES, YVETTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:
Last Name:BARRAZA-REYES
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 1:121 W WHITTIER BLVD
Mailing Address - Street 2:SUITE 23
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3893
Mailing Address - Country:US
Mailing Address - Phone:562-697-9796
Mailing Address - Fax:562-697-9787
Practice Address - Street 1:121 W WHITTIER BLVD
Practice Address - Street 2:SUITE 23
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3893
Practice Address - Country:US
Practice Address - Phone:562-697-9796
Practice Address - Fax:562-697-9787
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20336103TC0700X, 103TC1900X, 103TC2200X, 103T00000X
103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent