Healthcare Provider Details

I. General information

NPI: 1366195414
Provider Name (Legal Business Name): TRISTIE YUMUL-GOCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2022
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 ROLLING OAKS DR STE 110
THOUSAND OAKS CA
91361-1299
US

IV. Provider business mailing address

PO BOX 6514
WESTLAKE VILLAGE CA
91359-6514
US

V. Phone/Fax

Practice location:
  • Phone: 818-461-1610
  • Fax:
Mailing address:
  • Phone: 818-438-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: TRISTIE YUMUL
Title or Position: NURSE ANESTHETIST
Credential: CRNA
Phone: 818-438-8777