Individual
MS. YESENIA BAEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
Mailing address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35721
CA
Other
Enumeration date
02/13/2007
Last updated
05/13/2013
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