Healthcare Provider Details

I. General information

NPI: 1003099532
Provider Name (Legal Business Name): YOLANDA SMALDINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YOLANDA GUZMAN-SMALDINO RN

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14215 ROAD 28
MADERA CA
93638-5715
US

IV. Provider business mailing address

14215 ROAD 28
MADERA CA
93638-5715
US

V. Phone/Fax

Practice location:
  • Phone: 559-675-7893
  • Fax: 559-674-7267
Mailing address:
  • Phone: 559-675-7893
  • Fax: 559-674-7267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number670624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: