Provider Demographics
NPI:1871060962
Name:YEPIZ, LIZBETH (RBT)
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:YEPIZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 WHITE FALL CT
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-7407
Mailing Address - Country:US
Mailing Address - Phone:209-342-8622
Mailing Address - Fax:
Practice Address - Street 1:140 IVY AVE UNIT H58
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-8569
Practice Address - Country:US
Practice Address - Phone:209-402-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1865776103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst