Provider Demographics
NPI:1386530301
Name:YATACO, NYDIA GUADALUPE (MSW)
Entity type:Individual
Prefix:
First Name:NYDIA
Middle Name:GUADALUPE
Last Name:YATACO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:YATACO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21123
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-0123
Mailing Address - Country:US
Mailing Address - Phone:925-382-7997
Mailing Address - Fax:
Practice Address - Street 1:2240 GLADSTONE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5126
Practice Address - Country:US
Practice Address - Phone:925-431-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical