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Individual

DENISE YBARRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
104 W 4TH ST, SAN BERNARDINO, CA 92415-1403
(909) 382-7815
Mailing address
104 W 4TH ST, SAN BERNARDINO, CA 92415-0035
(909) 382-7815

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
175T00000X
Peer Specialist
CA
372500000X
Chore Provider
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175T00000X
CA
05
I518598879
CA
Enumeration date
01/27/2020
Last updated
04/18/2025
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