Provider Demographics
NPI:1568077345
Name:YORK, D'ANDRE (FNP-C, PNP)
Entity Type:Individual
Prefix:
First Name:D'ANDRE
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:FNP-C, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-1447
Mailing Address - Country:US
Mailing Address - Phone:760-427-7798
Mailing Address - Fax:
Practice Address - Street 1:702 WAKE AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-7502
Practice Address - Country:US
Practice Address - Phone:760-352-7216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily