Provider Demographics
NPI:1366677254
Name:YARCHUK, YANA (PA-C)
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:YARCHUK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:YANA
Other - Middle Name:
Other - Last Name:CHUVALDZHYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 N COLUMBUS AVE UNIT 306
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1689
Mailing Address - Country:US
Mailing Address - Phone:805-215-2925
Mailing Address - Fax:
Practice Address - Street 1:65 N MADISON AVE STE 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2050
Practice Address - Country:US
Practice Address - Phone:626-795-2110
Practice Address - Fax:626-795-7855
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20146363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical