MEDICARE: MRS. YUSTINI J. MENTE RNP

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
1	363L00000X	Nurse Practitioner	483138	CA

General Provider Information

NPI Number	:	1215122502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YUSTINI J. MENTE RNP

Provider Business Mailing Address
First Line	:	763 COLUSA DR
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-4528
Country	:	US
Telephone Number	:	626-912-3811
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 PALISADE ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-2056
Country	:	US
Telephone Number	:	616-794-7169
Fax Number	:	626-398-5177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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