Basic Information
Provider Information
NPI: 1154863405
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARCE
FirstName: YOLANDA
MiddleName: YVETTE
NamePrefix:  
NameSuffix:  
Credential: M.S.W.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2934 N FRESNO ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937031123
CountryCode: US
TelephoneNumber: 5595496697
FaxNumber:  
Practice Location
Address1: 2934 N FRESNO ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937031123
CountryCode: US
TelephoneNumber: 5595496697
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/16/2016
LastUpdateDate: 09/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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