Provider Demographics
NPI:1831487545
Name:YANEZ, JACQUELINE (MSW, ASW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:YANEZ
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:MIRAMONTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, ASW
Mailing Address - Street 1:3558 MIRAMAR CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1343 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4438
Practice Address - Country:US
Practice Address - Phone:209-725-1060
Practice Address - Fax:209-725-1064
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical