Healthcare Provider Details

I. General information

NPI: 1104273309
Provider Name (Legal Business Name): YEN ANKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24552 PACIFIC PARK DR
ALISO VIEJO CA
92656
US

IV. Provider business mailing address

40 MANZANILLO
LAKE FOREST CA
92630-1442
US

V. Phone/Fax

Practice location:
  • Phone: 949-565-2377
  • Fax:
Mailing address:
  • Phone: 949-468-9663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95003992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: