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General NPI Number Information
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NPI Number | 1407395734
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Entity Type | Organization
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Legal Business Name | INFINITY CARE HOUSECALL AND NURSING SERVICES
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 3300 E SOUTH ST STE 209
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City | LAKEWOOD
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State | CA
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Zip | 90805-4592
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Country | US
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Telephone | 818-322-7536
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Fax |
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Provider Business Mailing Address
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Address Line | 11331 183RD ST # 178
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City | CERRITOS
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State | CA
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Zip | 90703-5434
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Country | US
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Telephone | 818-322-7536
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Fax |
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Authorized Official
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Title or Position | NP/VICE PRESIDENT
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Name | EDNA YARASHEVICH
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Credential | NP
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Telephone | 818-322-7536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95001399
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License Number State | CA
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