Provider Demographics
NPI:1982441986
Name:YRG THERAPY, LICENSED CLINICAL SOCIAL WORKER CORPORATION
Entity type:Organization
Organization Name:YRG THERAPY, LICENSED CLINICAL SOCIAL WORKER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YALITTZA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-586-4124
Mailing Address - Street 1:29074 SHADOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-6833
Mailing Address - Country:US
Mailing Address - Phone:909-586-4124
Mailing Address - Fax:
Practice Address - Street 1:10832 LAUREL ST STE 102
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7688
Practice Address - Country:US
Practice Address - Phone:909-987-1997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty