Provider Demographics
NPI:1740504828
Name:FLORES, YESENIA (PHD)
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 CHAMBERS RD STE 219
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6962
Mailing Address - Country:US
Mailing Address - Phone:714-552-4752
Mailing Address - Fax:949-264-9490
Practice Address - Street 1:2522 CHAMBERS RD STE 219
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6962
Practice Address - Country:US
Practice Address - Phone:714-552-4752
Practice Address - Fax:949-264-9490
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-11-8237103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst