Provider Demographics
NPI:1699092585
Name:BRUINSMA, YVONNE ELISABETH (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:ELISABETH
Last Name:BRUINSMA
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BAYVIEW
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-7989
Mailing Address - Country:US
Mailing Address - Phone:949-533-6818
Mailing Address - Fax:949-726-8324
Practice Address - Street 1:3652 MICHELSON DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1727
Practice Address - Country:US
Practice Address - Phone:949-533-6818
Practice Address - Fax:949-726-8324
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-08-4278103K00000X
CA1-08-4278103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst