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General NPI Number Information
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NPI Number | 1609343102
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Entity Type | Individual
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Provider Name | YANYAN HOLLINGSWORTH PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 510 PLAZA DR STE 170
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City | FOLSOM
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State | CA
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Zip | 95630-4790
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Country | US
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Telephone | 916-351-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 187 FAIRGROUNDS DR
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City | SACRAMENTO
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State | CA
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Zip | 95817-2407
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Country | US
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Telephone | 616-425-1718
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 56197
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95010347
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95010347
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License Number State | CA
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