Provider Demographics
NPI:1992991053
Name:YATES, VICTORIA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10012 NORWALK BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3363
Mailing Address - Country:US
Mailing Address - Phone:562-906-1335
Mailing Address - Fax:
Practice Address - Street 1:10012 NORWALK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3363
Practice Address - Country:US
Practice Address - Phone:562-906-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32289167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician