Provider Demographics
NPI:1164742714
Name:YOCAM, RENEE ELISABETH DESIREE (DO)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ELISABETH DESIREE
Last Name:YOCAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14612 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6211
Mailing Address - Country:US
Mailing Address - Phone:714-731-1715
Mailing Address - Fax:714-558-3732
Practice Address - Street 1:1530 W 17TH ST
Practice Address - Street 2:JOHNSON CENTER, ROOM U120
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3398
Practice Address - Country:US
Practice Address - Phone:714-564-6216
Practice Address - Fax:714-558-3732
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-06
Last Update Date:2010-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine