Healthcare Provider Details

I. General information

NPI: 1598036931
Provider Name (Legal Business Name): DANIELLE ANN YBARRA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2012
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E CALVADA BLVD
PAHRUMP NV
89048-5807
US

IV. Provider business mailing address

PO BOX 98978
LAS VEGAS NV
89193-8978
US

V. Phone/Fax

Practice location:
  • Phone: 775-727-5509
  • Fax: 775-727-5696
Mailing address:
  • Phone: 702-507-2430
  • Fax: 702-671-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15664
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1329
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: