Provider Demographics
NPI:1467938829
Name:SOLIS, YVETTE ROSE (LVN)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:ROSE
Last Name:SOLIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:ROSE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:82790 MILLAY CT
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-9333
Mailing Address - Country:US
Mailing Address - Phone:760-989-9347
Mailing Address - Fax:
Practice Address - Street 1:47915 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6950
Practice Address - Country:US
Practice Address - Phone:760-863-8638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA694223164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty