Healthcare Provider Details

I. General information

NPI: 1982325973
Provider Name (Legal Business Name): REBECCA YECOSHENKO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29129 TOPEKA CIR
WINCHESTER CA
92596-9627
US

IV. Provider business mailing address

29129 TOPEKA CIR
WINCHESTER CA
92596-9627
US

V. Phone/Fax

Practice location:
  • Phone: 951-515-3195
  • Fax:
Mailing address:
  • Phone: 951-515-3195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95002696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: