Provider Demographics
NPI:1306640537
Name:HERRERA, SANDRA YOLANDA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:YOLANDA
Last Name:HERRERA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 ROBERTS AVE APT 1D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5130
Mailing Address - Country:US
Mailing Address - Phone:646-894-7128
Mailing Address - Fax:
Practice Address - Street 1:3150 ROBERTS AVE APT 1D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5130
Practice Address - Country:US
Practice Address - Phone:646-894-7128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty