Provider Demographics
NPI:1295508430
Name:WARREN, YIENESSA DESHAYE (MFT TRAINEE)
Entity type:Individual
Prefix:
First Name:YIENESSA
Middle Name:DESHAYE
Last Name:WARREN
Suffix:
Gender:F
Credentials:MFT TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 PASEO VERDE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-6501
Mailing Address - Country:US
Mailing Address - Phone:760-885-1550
Mailing Address - Fax:
Practice Address - Street 1:7310 SMOKE RANCH RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0258
Practice Address - Country:US
Practice Address - Phone:702-670-0090
Practice Address - Fax:702-522-6075
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician