Provider Demographics
NPI:1972276236
Name:FLORES, YESENIA (LAC, DACM)
Entity Type:Individual
Prefix:DR
First Name:YESENIA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5024
Mailing Address - Country:US
Mailing Address - Phone:619-440-2440
Mailing Address - Fax:619-440-9440
Practice Address - Street 1:1149 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5024
Practice Address - Country:US
Practice Address - Phone:619-440-2440
Practice Address - Fax:619-440-9440
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19135171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist