Provider Demographics
NPI:1316204613
Name:YONGA, SIMPLICE
Entity Type:Individual
Prefix:
First Name:SIMPLICE
Middle Name:
Last Name:YONGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 RHODE ISLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1802
Mailing Address - Country:US
Mailing Address - Phone:202-832-1698
Mailing Address - Fax:202-832-0980
Practice Address - Street 1:3730 MINNESOTA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2667
Practice Address - Country:US
Practice Address - Phone:202-301-5204
Practice Address - Fax:202-832-1698
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 171M00000X
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No374U00000XNursing Service Related ProvidersHome Health Aide