Healthcare Provider Details

I. General information

NPI: 1750501375
Provider Name (Legal Business Name): WOODRYAN YVETTE ALEXANDER CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WOODRYAN YVETTE RICHARDSON

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24444 VALENCIA BLVD APT. 1202
VALENCIA CA
91355-1822
US

IV. Provider business mailing address

24444 VALENCIA BLVD APT. 1202
VALENCIA CA
91355-1822
US

V. Phone/Fax

Practice location:
  • Phone: 626-536-7644
  • Fax: 661-310-0354
Mailing address:
  • Phone: 626-536-7644
  • Fax: 661-310-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number301477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: