Provider Demographics
NPI:1326930090
Name:BROWN, YVETTE MICHELLE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:MICHELLE
Other - Last Name:KEENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1711 SHASTA ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3249
Mailing Address - Country:US
Mailing Address - Phone:409-499-8875
Mailing Address - Fax:
Practice Address - Street 1:1300 HILLTOP DR STE 200
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-3874
Practice Address - Country:US
Practice Address - Phone:530-618-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-HIGDOJ175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist