Healthcare Provider Details

I. General information

NPI: 1972148070
Provider Name (Legal Business Name): ROSALIND RENEE YARBER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 RUSTIN AVE
RIVERSIDE CA
92507-2498
US

IV. Provider business mailing address

PO BOX 5390
RIVERSIDE CA
92517-5390
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-7320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN192317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: