Healthcare Provider Details

I. General information

NPI: 1689660318
Provider Name (Legal Business Name): YVONNE EMILY JACKSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 VETERANS MEMORIAL CIRCLE SUTTER COUNTY HEALTH DEPT CLINIC
YUBA CITY CA
95993
US

IV. Provider business mailing address

2145 5TH AVE
OROVILLE CA
95965-5870
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7240
  • Fax: 530-822-7105
Mailing address:
  • Phone: 530-534-5394
  • Fax: 530-534-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN217802
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: