Provider Demographics
NPI:1952779068
Name:LEVCHENKO, YOLANDA BELEN (RDHAP)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:BELEN
Last Name:LEVCHENKO
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 ALVORD LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-5101
Mailing Address - Country:US
Mailing Address - Phone:424-400-1187
Mailing Address - Fax:
Practice Address - Street 1:2401 ALVORD LN
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-5101
Practice Address - Country:US
Practice Address - Phone:424-400-1187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583124Q00000X
CA25870124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist