Provider Demographics
NPI:1114432721
Name:YOSHISAKI, MAY FARRAH BLANCO (NSN-FNP)
Entity Type:Individual
Prefix:
First Name:MAY FARRAH
Middle Name:BLANCO
Last Name:YOSHISAKI
Suffix:
Gender:F
Credentials:NSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39525 LOS ALAMOS RD STE E
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5027
Mailing Address - Country:US
Mailing Address - Phone:951-461-0540
Mailing Address - Fax:
Practice Address - Street 1:39525 LOS ALAMOS ROAD
Practice Address - Street 2:STE E
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563
Practice Address - Country:US
Practice Address - Phone:951-461-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007876363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily