Provider Demographics
NPI:1801009600
Name:ARELLANO, YVETTE MARIE (DOM, LMT)
Entity type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:MARIE
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:DOM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40678
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87196
Mailing Address - Country:US
Mailing Address - Phone:505-269-0925
Mailing Address - Fax:
Practice Address - Street 1:9412 INDIAN SCHOOL, NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112
Practice Address - Country:US
Practice Address - Phone:505-269-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM842171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00RD49OtherBCBS