MEDICARE: MARIAM YOKHANA RN

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	163WC0400X	Case Management Registered Nurse	95182069	CA
2	163WI0500X	Infusion Therapy Registered Nurse	95182069	CA
3	163WX0200X	Oncology Registered Nurse	95182069	CA
4	163W00000X	Registered Nurse	95182069	CA

General Provider Information

NPI Number	:	1326831652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAM YOKHANA RN

Provider Business Mailing Address
First Line	:	1651 FEDERAL AVE APT 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2968
Country	:	US
Telephone Number	:	773-556-3204
Fax Number	:

Provider Business Practice Location Address
First Line	:	1651 FEDERAL AVE APT 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2968
Country	:	US
Telephone Number	:	773-556-3204
Fax Number	:

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

Provider Enumeration Date	:	05/28/2025
Last Update Date	:	05/28/2025

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