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General NPI Number Information
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NPI Number | 1073403085
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Entity Type | Individual
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Provider Name | KATHERINE ALEXIS YALE
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1381 W CHANNEL ISLANDS BLVD
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City | OXNARD
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State | CA
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Zip | 93033-4203
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Country | US
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Telephone | 805-253-1796
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Fax |
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Provider Business Mailing Address
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Address Line | 10316 MASON AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-3305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS111660
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License Number State | CA
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