Provider Demographics
NPI:1619563129
Name:BUICH, YVETTE (RN, PHN)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:BUICH
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:
Other - Last Name:BUICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:YVETTE BANCHERO
Mailing Address - Street 1:64 HAGEN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2207
Mailing Address - Country:US
Mailing Address - Phone:925-876-5016
Mailing Address - Fax:
Practice Address - Street 1:64 HAGEN OAKS CT
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-2207
Practice Address - Country:US
Practice Address - Phone:925-876-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398098163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty