Provider Demographics
NPI:1528541034
Name:YOB, AMARA K (RN)
Entity Type:Individual
Prefix:
First Name:AMARA
Middle Name:K
Last Name:YOB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 17TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1216
Mailing Address - Country:US
Mailing Address - Phone:608-712-9914
Mailing Address - Fax:
Practice Address - Street 1:1241 17TH ST APT 6
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1216
Practice Address - Country:US
Practice Address - Phone:608-712-9914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711968163W00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163W00000XNursing Service ProvidersRegistered Nurse