Provider Demographics
NPI:1043058860
Name:YANEZ, TERRY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:YANEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:WALTIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 W BIRCH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4504
Mailing Address - Country:US
Mailing Address - Phone:714-494-6252
Mailing Address - Fax:
Practice Address - Street 1:210 W BIRCH ST STE 206
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4504
Practice Address - Country:US
Practice Address - Phone:714-494-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA82122355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant