Basic Information
Provider Information
NPI: 1467899195
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOPEZ DELGADO
FirstName: YARLENE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 602 E NOB HILL BLVD
Address2:  
City: YAKIMA
State: WA
PostalCode: 989013534
CountryCode: US
TelephoneNumber: 5092483334
FaxNumber: 5094536144
Practice Location
Address1: 602 E NOB HILL BLVD
Address2:  
City: YAKIMA
State: WA
PostalCode: 989013534
CountryCode: US
TelephoneNumber: 5092483334
FaxNumber: 5094536144
Other Information
ProviderEnumerationDate: 06/04/2013
LastUpdateDate: 03/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPY9331FLN Behavioral Health & Social Service ProvidersPsychologistClinical
103TC0700X3115PRN Behavioral Health & Social Service ProvidersPsychologistClinical
103TC0700XPY60916160WAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home