| Doctor Name: | STEPHANIE MADALYN YODER |
| NPI Number: | 1265850630 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, FNP-BC |
| License Number: | 95000572 |
| Business Practice Address: | 877 Oak Park Blvd Pismo Beach, CA - 934493292 |
| Business Phone Number: | 8054748450 |
| Business Fax Number: | 8054748454 |
| Mailing Address: | 504 Plaza Drive, SANTA MARIA |
| State: | CA |
| Postal Code: | 934546917 |
| Phone Number: | 8057393474 |
| Fax Number: | 8053463548 |
| NPI Enumeration Date: | 04/02/2014 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95000572 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |