Provider Demographics
NPI:1720623184
Name:YESSICA AVANCENA, LMFT CORP
Entity Type:Organization
Organization Name:YESSICA AVANCENA, LMFT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVANCENA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:661-304-7570
Mailing Address - Street 1:11000 BRIMHALL RD STE E
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3022
Mailing Address - Country:US
Mailing Address - Phone:661-304-7570
Mailing Address - Fax:661-829-7301
Practice Address - Street 1:1701 WESTWIND DR STE 111
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3045
Practice Address - Country:US
Practice Address - Phone:661-304-7570
Practice Address - Fax:661-829-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty