Provider Demographics
NPI:1700601374
Name:CONDE, YANCI LISSETTE
Entity type:Individual
Prefix:
First Name:YANCI
Middle Name:LISSETTE
Last Name:CONDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 MAHAN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1633
Mailing Address - Country:US
Mailing Address - Phone:510-375-6519
Mailing Address - Fax:
Practice Address - Street 1:1849 WILLOW PASS RD # 420
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2524
Practice Address - Country:US
Practice Address - Phone:925-672-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA76222355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant