Healthcare Provider Details

I. General information

NPI: 1407590300
Provider Name (Legal Business Name): KIMBERLY ERIN YEE NP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 N RIVER RD
OCEANSIDE CA
92057-6043
US

IV. Provider business mailing address

1000 VALE TERRACE DR
VISTA CA
92084-5218
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-5000
  • Fax:
Mailing address:
  • Phone: 760-631-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95019770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: