Provider Demographics
NPI:1053600890
Name:YATSENKO, ANNA (DC)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:YATSENKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:YATSENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:11850 HESPERIA RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-2173
Mailing Address - Country:US
Mailing Address - Phone:760-995-4500
Mailing Address - Fax:760-995-4501
Practice Address - Street 1:11850 HESPERIA RD
Practice Address - Street 2:SUITE 11
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-2173
Practice Address - Country:US
Practice Address - Phone:760-995-4500
Practice Address - Fax:760-995-4501
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor