Provider Demographics
NPI:1124630710
Name:BATRES, YENI
Entity type:Individual
Prefix:
First Name:YENI
Middle Name:
Last Name:BATRES
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 1:441 E CARSON ST STE J
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-7712
Mailing Address - Country:US
Mailing Address - Phone:424-392-4984
Mailing Address - Fax:
Practice Address - Street 1:441 E CARSON ST STE J
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-7712
Practice Address - Country:US
Practice Address - Phone:424-392-4984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist