Healthcare Provider Details

I. General information

NPI: 1801549100
Provider Name (Legal Business Name): YESSENIA LUNA TOSCANO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 E FLORIDA AVE
HEMET CA
92543-4513
US

IV. Provider business mailing address

1207 E FLORIDA AVE
HEMET CA
92543-4513
US

V. Phone/Fax

Practice location:
  • Phone: 951-925-2523
  • Fax:
Mailing address:
  • Phone: 951-925-2523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: