Provider Demographics
NPI:1245575133
Name:YORK, DELELLIS (RN)
Entity Type:Individual
Prefix:
First Name:DELELLIS
Middle Name:
Last Name:YORK
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 1:5730 PACKARD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-7118
Mailing Address - Country:US
Mailing Address - Phone:530-749-6311
Mailing Address - Fax:530-749-6397
Practice Address - Street 1:5730 PACKARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-7118
Practice Address - Country:US
Practice Address - Phone:530-749-6311
Practice Address - Fax:530-749-6397
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA638700163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management