Provider Demographics
NPI:1982903068
Name:YAP, JESUSA CARAS (RN, CCM)
Entity Type:Individual
Prefix:MS
First Name:JESUSA
Middle Name:CARAS
Last Name:YAP
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:MS
Other - First Name:JESUSA
Other - Middle Name:CARAS
Other - Last Name:YAP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CCM
Mailing Address - Street 1:200 LOS BANOS AVE
Mailing Address - Street 2:200 LOS BANOS AVENUE
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1063
Mailing Address - Country:US
Mailing Address - Phone:650-922-5635
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA
Practice Address - Street 2:CMR 4, BLDG 700, ROSE BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:49966-283-4719
Practice Address - Fax:49966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN280256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOOtherUPIN