MEDICARE: YESSENIA YASMIN MACHADO-ROSSELLE

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	163WP2201X	Ambulatory Care Registered Nurse	95021699	CA

General Provider Information

NPI Number	:	1255921748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YESSENIA YASMIN MACHADO-ROSSELLE

Provider Business Mailing Address
First Line	:	9890 AUSTIN DR
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-3404
Country	:	US
Telephone Number	:	619-992-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	9890 AUSTIN DR
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-3404
Country	:	US
Telephone Number	:	619-992-4164
Fax Number	:

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

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/19/2021

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Directions to “ YESSENIA YASMIN MACHADO-ROSSELLE ” Practice Location

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