Provider Demographics
NPI:1740077692
Name:BECKLES, YAJAIRA MICHELLE
Entity type:Individual
Prefix:
First Name:YAJAIRA
Middle Name:MICHELLE
Last Name:BECKLES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 WILLOW RD APT 28
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2654
Mailing Address - Country:US
Mailing Address - Phone:650-804-3012
Mailing Address - Fax:
Practice Address - Street 1:280 EDMONDS RD BLDG B
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-3813
Practice Address - Country:US
Practice Address - Phone:650-479-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program