Provider Demographics
NPI:1841335130
Name:YGLESIAS, LUCILLE ANDREA
Entity type:Individual
Prefix:MS
First Name:LUCILLE
Middle Name:ANDREA
Last Name:YGLESIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3150
Mailing Address - Country:US
Mailing Address - Phone:909-798-9595
Mailing Address - Fax:951-737-2783
Practice Address - Street 1:623 N MAIN ST
Practice Address - Street 2:SUITE D-11
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-1407
Practice Address - Country:US
Practice Address - Phone:951-737-2962
Practice Address - Fax:951-737-2783
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)