Provider Demographics
NPI:1407395734
Name:INFINITY CARE HOUSECALL AND NURSING SERVICES
Entity Type:Organization
Organization Name:INFINITY CARE HOUSECALL AND NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YARASHEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-322-7536
Mailing Address - Street 1:11331 183RD ST # 178
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5434
Mailing Address - Country:US
Mailing Address - Phone:818-322-7536
Mailing Address - Fax:
Practice Address - Street 1:3300 E SOUTH ST STE 209
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90805-4592
Practice Address - Country:US
Practice Address - Phone:818-322-7536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty