Provider Demographics
NPI:1386245488
Name:YRIGOLLEN, ELENA A (BS)
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:A
Last Name:YRIGOLLEN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5325 N FRESNO ST STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6849
Mailing Address - Country:US
Mailing Address - Phone:877-418-2977
Mailing Address - Fax:866-500-2187
Practice Address - Street 1:3043 W ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-2160
Practice Address - Country:US
Practice Address - Phone:559-352-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician