Provider Demographics
NPI:1811022395
Name:VASQUEZ, YOLANDA (MFT)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 TUOLUMNE ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5700
Mailing Address - Country:US
Mailing Address - Phone:707-553-5820
Mailing Address - Fax:707-553-5824
Practice Address - Street 1:355 TUOLUMNE ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5700
Practice Address - Country:US
Practice Address - Phone:707-553-5820
Practice Address - Fax:707-553-5824
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
CAMFC52247106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health