Healthcare Provider Details

I. General information

NPI: 1316090103
Provider Name (Legal Business Name): MARIA VELMA YEP DNP, APRN, GNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9190 HAVEN AVE STE 102
RANCHO CUCAMONGA CA
91730-5431
US

IV. Provider business mailing address

9190 HAVEN AVE STE 102
RANCHO CUCAMONGA CA
91730-5431
US

V. Phone/Fax

Practice location:
  • Phone: 909-527-8110
  • Fax: 909-581-6738
Mailing address:
  • Phone: 909-527-8110
  • Fax: 909-581-6738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP13575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: