Provider Demographics
NPI:1558502591
Name:YODER, JEANNE RENE (CRNA)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:RENE
Last Name:YODER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 FELL ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1850
Mailing Address - Country:US
Mailing Address - Phone:415-752-9644
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST # SF
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6653
Is Sole Proprietor?:No
Enumeration Date:2009-03-22
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3761367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered