Healthcare Provider Details

I. General information

NPI: 1639492895
Provider Name (Legal Business Name): YASMIN CECILE EMBDEN C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W ALAMEDA AVE SUITE 602
BURBANK CA
91505-4402
US

IV. Provider business mailing address

2766 W LOMA VISTA DR
RIALTO CA
92377-3446
US

V. Phone/Fax

Practice location:
  • Phone: 818-840-8335
  • Fax: 818-843-7384
Mailing address:
  • Phone: 909-350-2829
  • Fax: 909-350-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number239252
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: