Provider Demographics
NPI:1336341270
Name:FRAIJO, YVETTE MARIE (MA)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:MARIE
Last Name:FRAIJO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:YVETTE
Other - Middle Name:GARCIA
Other - Last Name:FRAIJO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1813 S ROCKWELL ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-5199
Mailing Address - Country:US
Mailing Address - Phone:480-219-1705
Mailing Address - Fax:
Practice Address - Street 1:2935 S. RECKER ROAD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-279-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist