Provider Demographics
NPI:1588307243
Name:YANCHISIN, JULIANA (LMSW)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:YANCHISIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7478 LA PINE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-9298
Mailing Address - Country:US
Mailing Address - Phone:702-908-9711
Mailing Address - Fax:
Practice Address - Street 1:8620 W EMERALD ST STE 150
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4839
Practice Address - Country:US
Practice Address - Phone:208-617-3265
Practice Address - Fax:208-617-3270
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical