Provider Demographics
NPI:1417722307
Name:MOSLEY, YOLANDA SANDTANA
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:SANDTANA
Last Name:MOSLEY
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 1:1530 E 124TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-2924
Mailing Address - Country:US
Mailing Address - Phone:562-200-1877
Mailing Address - Fax:
Practice Address - Street 1:1530 E 124TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-2924
Practice Address - Country:US
Practice Address - Phone:562-200-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACRTIFICATION374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula