Provider Demographics
NPI:1588431431
Name:PULIDO, YARELI MADELIN
Entity type:Individual
Prefix:
First Name:YARELI
Middle Name:MADELIN
Last Name:PULIDO
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 1:9528 MIRAMAR RD # 1160
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4533
Mailing Address - Country:US
Mailing Address - Phone:786-400-9686
Mailing Address - Fax:
Practice Address - Street 1:7269 ROXANNE LN
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2961
Practice Address - Country:US
Practice Address - Phone:786-400-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician