Provider Demographics
NPI:1598929960
Name:YSIP, NOEL D (FNP)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:D
Last Name:YSIP
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-5000
Mailing Address - Country:US
Mailing Address - Phone:619-881-9021
Mailing Address - Fax:619-216-5509
Practice Address - Street 1:2300 BOSWELL RD STE 190
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3535
Practice Address - Country:US
Practice Address - Phone:619-881-9021
Practice Address - Fax:619-216-5509
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily