Healthcare Provider Details

I. General information

NPI: 1821246216
Provider Name (Legal Business Name): YOLANDA NMI VARGAS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

13921 HAWES ST
WHITTIER CA
90605-2627
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax:
Mailing address:
  • Phone: 562-696-9011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number403325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: