Provider Demographics
NPI:1215564513
Name:CETINA, YLIANA (OD)
Entity Type:Individual
Prefix:DR
First Name:YLIANA
Middle Name:
Last Name:CETINA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3902
Mailing Address - Country:US
Mailing Address - Phone:702-385-2242
Mailing Address - Fax:702-382-7955
Practice Address - Street 1:1300 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3902
Practice Address - Country:US
Practice Address - Phone:702-385-2242
Practice Address - Fax:702-382-7955
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34625152W00000X
NV1058152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist