Basic Information
Provider Information
NPI: 1255881512
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OQUENDO-FIGUEROA
FirstName: YAIRA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 E ROGERS RD
Address2:  
City: LONGMONT
State: CO
PostalCode: 805016027
CountryCode: US
TelephoneNumber: 3036972583
FaxNumber:  
Practice Location
Address1: 220 E ROGERS RD
Address2:  
City: LONGMONT
State: CO
PostalCode: 805016027
CountryCode: US
TelephoneNumber: 3036972583
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/11/2016
LastUpdateDate: 10/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X0004488COY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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