Provider Demographics
NPI:1558439604
Name:YEAGER, JOLINE LINDEL (PAC)
Entity Type:Individual
Prefix:MRS
First Name:JOLINE
Middle Name:LINDEL
Last Name:YEAGER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:JOLINE
Other - Middle Name:LINDEL
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 N EUCLID ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4115
Mailing Address - Country:US
Mailing Address - Phone:714-517-2100
Mailing Address - Fax:714-490-1973
Practice Address - Street 1:710 N EUCLID ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4115
Practice Address - Country:US
Practice Address - Phone:714-517-2100
Practice Address - Fax:714-490-1973
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14469363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant