Provider Demographics
NPI:1497338958
Name:YALDO, ATHMAR MARY (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ATHMAR
Middle Name:MARY
Last Name:YALDO
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 HIGHLAND AVE # 200
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5207
Mailing Address - Country:US
Mailing Address - Phone:619-930-9404
Mailing Address - Fax:
Practice Address - Street 1:328 HIGHLAND AVE # 200
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5207
Practice Address - Country:US
Practice Address - Phone:619-930-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016817363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care