Healthcare Provider Details

I. General information

NPI: 1154030948
Provider Name (Legal Business Name): CAROLINE GASPI-YAZAR LABITIGAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46392 LONE PINE DR
TEMECULA CA
92592-4141
US

IV. Provider business mailing address

46392 LONE PINE DR
TEMECULA CA
92592-4141
US

V. Phone/Fax

Practice location:
  • Phone: 951-308-1129
  • Fax:
Mailing address:
  • Phone: 951-308-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95022124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: