Healthcare Provider Details

I. General information

NPI: 1881312577
Provider Name (Legal Business Name): NANKING YEE-MARTINEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23925 NEWHALL RANCH RD
SANTA CLARITA CA
91355-5701
US

IV. Provider business mailing address

17188 CHATSWORTH ST
GRANADA HILLS CA
91344-5727
US

V. Phone/Fax

Practice location:
  • Phone: 661-255-7551
  • Fax:
Mailing address:
  • Phone: 818-321-6491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95163445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: