Doctor Name: | MS. YOLANDA MATA |
NPI Number: | 1003123183 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 18836 |
Business Practice Address: | 257 N Dewitt Ave Fresno, CA - 937273312 |
Business Phone Number: | 5592551373 |
Business Fax Number: | |
Mailing Address: | 257 N Dewitt Ave, FRESNO |
State: | CA |
Postal Code: | 937273312 |
Phone Number: | 5592551373 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2010 |
NPI Last Update Date: | 09/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 18836 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |