Provider Demographics
NPI:1104969427
Name:YANEZ, EVETTE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:EVETTE
Middle Name:MARIE
Last Name:YANEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N MCKINLEY ST STE 111-378
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-8099
Mailing Address - Country:US
Mailing Address - Phone:562-965-6748
Mailing Address - Fax:
Practice Address - Street 1:9890 COUNTY FARM RD STE 2
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3678
Practice Address - Country:US
Practice Address - Phone:951-539-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23985103TC0700X
CAPSY 23985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical