Provider Demographics
NPI:1952662561
Name:YOUSSEF, HELENA BOTROS (MPP)
Entity Type:Individual
Prefix:MRS
First Name:HELENA
Middle Name:BOTROS
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:MPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SUNWEST LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0019
Mailing Address - Country:US
Mailing Address - Phone:909-252-4010
Mailing Address - Fax:
Practice Address - Street 1:1950 SUNWEST LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0019
Practice Address - Country:US
Practice Address - Phone:909-252-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA8904108390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program