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General NPI Number Information
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NPI Number | 1992680144
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Entity Type | Individual
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Provider Name | YESSICA MARIA COOSEMANS NOVALES DDS
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1423 E GAGE AVE STE A
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City | LOS ANGELES
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State | CA
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Zip | 90001-1771
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Country | US
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Telephone | 323-983-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 19721 ALYSSA DR
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2144
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Country | US
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Telephone | 661-644-9238
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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 | 112206
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License Number State | CA
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