Provider Demographics
NPI:1972952349
Name:YANEZ, PRECILIANA (LPT)
Entity Type:Individual
Prefix:
First Name:PRECILIANA
Middle Name:
Last Name:YANEZ
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 KNIGHTS ROW
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2825
Mailing Address - Country:US
Mailing Address - Phone:530-237-7558
Mailing Address - Fax:
Practice Address - Street 1:564 S DORA ST
Practice Address - Street 2:STE. D
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482
Practice Address - Country:US
Practice Address - Phone:707-472-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38062167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician