Provider Demographics
NPI:1164077889
Name:YANI, NANCY M
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:YANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TERRASTAR LN
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0729
Mailing Address - Country:US
Mailing Address - Phone:949-302-1956
Mailing Address - Fax:
Practice Address - Street 1:23141 VERDUGO DR STE 103
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1341
Practice Address - Country:US
Practice Address - Phone:949-688-7075
Practice Address - Fax:949-688-6617
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist