Provider Demographics
NPI:1104516566
Name:YEPEZ, YULIANA
Entity type:Individual
Prefix:
First Name:YULIANA
Middle Name:
Last Name:YEPEZ
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 1:771 ALLACANTE DR
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-7307
Mailing Address - Country:US
Mailing Address - Phone:209-505-3948
Mailing Address - Fax:209-632-9008
Practice Address - Street 1:653 N GOLDEN STATE BLVD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3952
Practice Address - Country:US
Practice Address - Phone:209-634-5831
Practice Address - Fax:209-632-9008
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH98375183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician