Provider Demographics
NPI:1306143862
Name:PHILLIPS ALDAMA, YVETTE
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:
Last Name:PHILLIPS ALDAMA
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 1:3356 ADELINE ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2737
Mailing Address - Country:US
Mailing Address - Phone:510-985-0500
Mailing Address - Fax:510-985-8358
Practice Address - Street 1:3356 ADELINE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2737
Practice Address - Country:US
Practice Address - Phone:510-985-0500
Practice Address - Fax:510-985-8358
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator