Provider Demographics
NPI:1740323518
Name:MERCHANT, YVETTE DARLENE (CATC)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:DARLENE
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 DAMIEN AVE
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-4108
Mailing Address - Country:US
Mailing Address - Phone:909-625-7207
Mailing Address - Fax:909-626-1524
Practice Address - Street 1:790 E BONITA AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-1906
Practice Address - Country:US
Practice Address - Phone:909-625-7507
Practice Address - Fax:909-626-1524
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA051196 C.A.T.C.101YA0400X
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABON0003OtherMIS #