Provider Demographics
NPI:1376211607
Name:YARMAN, RENEE JO
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:JO
Last Name:YARMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WIXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-6139
Mailing Address - Country:US
Mailing Address - Phone:801-920-9452
Mailing Address - Fax:
Practice Address - Street 1:840 WIXFORD WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-6139
Practice Address - Country:US
Practice Address - Phone:801-920-9452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID26733163W00000X
OR201607243RN163W00000X
NV815212163W00000X
WARN60689508163W00000X
CA95110417163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse