Provider Demographics
NPI:1265133938
Name:HERRERA, YAZELL
Entity type:Individual
Prefix:
First Name:YAZELL
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E BEACH ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4704
Mailing Address - Country:US
Mailing Address - Phone:831-728-0222
Mailing Address - Fax:
Practice Address - Street 1:416 BERRY RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAKS
Practice Address - State:CA
Practice Address - Zip Code:95076-5622
Practice Address - Country:US
Practice Address - Phone:831-461-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator