MEDICARE: MRS. NITA MARZO YLLERA LVN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	VN 98696	CA

General Provider Information

NPI Number	:	1215183389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NITA MARZO YLLERA LVN

Provider Business Mailing Address
First Line	:	2235 GOLDEN DEW CIR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1441
Country	:	US
Telephone Number	:	408-238-5567
Fax Number	:

Provider Business Practice Location Address
First Line	:	1274 CITY VIEW PL
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-4333
Country	:	US
Telephone Number	:	408-254-1040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	08/14/2008

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