Provider Demographics
NPI:1629371505
Name:YONG, ROWENA MARY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:MARY
Last Name:YONG
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MOUNT VERNON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3302
Mailing Address - Country:US
Mailing Address - Phone:661-868-0241
Mailing Address - Fax:661-868-0269
Practice Address - Street 1:1800 MOUNT VERNON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0241
Practice Address - Fax:661-868-0269
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA327499302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization