Doctor Name: | MS. KELLEY LYNN YANES |
NPI Number: | 1548491012 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 17440 |
Business Practice Address: | 1970 Joseph Dr Moraga, CA - 945562713 |
Business Phone Number: | 9256310667 |
Business Fax Number: | 9256310495 |
Mailing Address: | 1970 Joseph Drive, MORAGA |
State: | CA |
Postal Code: | 945562713 |
Phone Number: | 9256310667 |
Fax Number: | 9256310495 |
NPI Enumeration Date: | 08/01/2009 |
NPI Last Update Date: | 06/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 17440 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |