Provider Demographics
NPI:1396963096
Name:FUENTES, YOLANDA (LBSW)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:FUENTES
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 RIGSBY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-3021
Mailing Address - Country:US
Mailing Address - Phone:210-532-5806
Mailing Address - Fax:
Practice Address - Street 1:13430 WEST AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2005
Practice Address - Country:US
Practice Address - Phone:210-490-4300
Practice Address - Fax:210-490-5196
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS24434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker