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NPI Code Detail

MEDICARE: RANDI N. YODER

MEDICARE: RANDI N. YODER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1124314018
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDI N. YODER
Provider Business Mailing Address
First Line : 415 LYONCROSS WAY
Second Line :
City : SAN JOSE
State : CA
Zip : 95123-3421
Country : US
Telephone Number : 574-596-5237
Fax Number :
Provider Business Practice Location Address
First Line : 3789 HOOVER ST
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-4504
Country : US
Telephone Number : 650-363-8735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 06/20/2011

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Directions to “ RANDI N. YODER ” Practice Location

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