MEDICARE: YASMIN GAETA

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	376K00000X	Nurse's Aide	00053884	CA

General Provider Information

NPI Number	:	1689365421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASMIN GAETA

Provider Business Mailing Address
First Line	:	1512 W I ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-4531
Country	:	US
Telephone Number	:	669-350-4352
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 W I ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-4531
Country	:	US
Telephone Number	:	669-350-4352
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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Directions to “ YASMIN GAETA ” Practice Location

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