Individual
YEDID AZAIRA MONDRAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
649 E ALBERTONI ST STE 100, CARSON, CA 90746-1538
(310) 436-9300
Mailing address
649 E ALBERTONI ST STE 100, CARSON, CA 90746-1538
(310) 436-9300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-KSQMDE
CA
Other
Enumeration date
07/15/2019
Last updated
06/23/2023
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