Provider Demographics
NPI:1639665888
Name:YAQOBI, SAFA TOKHI (FNP)
Entity Type:Individual
Prefix:
First Name:SAFA
Middle Name:TOKHI
Last Name:YAQOBI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:196-515-2300
Mailing Address - Fax:619-237-1856
Practice Address - Street 1:1550 BROADWAY STE 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-5713
Practice Address - Country:US
Practice Address - Phone:619-515-2525
Practice Address - Fax:619-501-5817
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2023-11-28
Deactivation Date:2018-08-14
Deactivation Code:
Reactivation Date:2023-11-28
Provider Licenses
StateLicense IDTaxonomies
CA95024887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily