Provider Demographics
NPI:1699518365
Name:AVENDANO, YESENIA
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:AVENDANO
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 1:811 W TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-3009
Mailing Address - Country:US
Mailing Address - Phone:805-265-4894
Mailing Address - Fax:805-856-0343
Practice Address - Street 1:811 W TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-3009
Practice Address - Country:US
Practice Address - Phone:805-265-4894
Practice Address - Fax:805-856-0343
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other