Provider Demographics
NPI:1396014999
Name:HERNANDEZ CACERES, YEDRIT BELEM
Entity type:Individual
Prefix:
First Name:YEDRIT
Middle Name:BELEM
Last Name:HERNANDEZ CACERES
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 1:10000 IMPERIAL HWY
Mailing Address - Street 2:H106
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3243
Mailing Address - Country:US
Mailing Address - Phone:562-418-9254
Mailing Address - Fax:
Practice Address - Street 1:2939 E PACIFIC COMMERCE DR
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-5729
Practice Address - Country:US
Practice Address - Phone:310-631-5918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner