Provider Demographics
NPI:1184857989
Name:AVILA, YAISELYN (RN)
Entity Type:Individual
Prefix:MRS
First Name:YAISELYN
Middle Name:
Last Name:AVILA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 SOLANO AVE
Mailing Address - Street 2:APT 239
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2767
Mailing Address - Country:US
Mailing Address - Phone:707-294-0238
Mailing Address - Fax:
Practice Address - Street 1:900 COOMBS ST
Practice Address - Street 2:SUITE 257
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2903
Practice Address - Country:US
Practice Address - Phone:707-253-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA522276163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse