Provider Demographics
NPI:1376201723
Name:YATSKAR, AMBER LYNN (DNP, APRN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:YATSKAR
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 RIDGELEY DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0706
Mailing Address - Country:US
Mailing Address - Phone:203-814-9009
Mailing Address - Fax:
Practice Address - Street 1:1482 RIDGELEY DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0706
Practice Address - Country:US
Practice Address - Phone:203-814-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10232363LF0000X
CA95019880363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily