Provider Demographics
NPI:1215183389
Name:YLLERA, NITA MARZO (LVN)
Entity Type:Individual
Prefix:MRS
First Name:NITA
Middle Name:MARZO
Last Name:YLLERA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 GOLDEN DEW CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1441
Mailing Address - Country:US
Mailing Address - Phone:408-238-5567
Mailing Address - Fax:
Practice Address - Street 1:1274 CITY VIEW PL
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-4333
Practice Address - Country:US
Practice Address - Phone:408-254-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 98696164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse