MEDICARE: PATRICIA YSABELLE EUSALA

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	163W00000X	Registered Nurse	95139003	CA

General Provider Information

NPI Number	:	1679410955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA YSABELLE EUSALA

Provider Business Mailing Address
First Line	:	1441 BUTLER AVE APT 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2485
Country	:	US
Telephone Number	:	818-983-9280
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 BUTLER AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2482
Country	:	US
Telephone Number	:	818-983-9280
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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