Healthcare Provider Details

I. General information

NPI: 1023658739
Provider Name (Legal Business Name): CAROLYN P YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 E RIVIERA DR
TEMPE AZ
85282-6044
US

IV. Provider business mailing address

334 W EL FREDA RD
TEMPE AZ
85284-5267
US

V. Phone/Fax

Practice location:
  • Phone: 480-590-3068
  • Fax: 480-590-3068
Mailing address:
  • Phone: 480-241-9220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: