Provider Demographics
NPI:1669861522
Name:AVILA-CAO, YVETTE M (RN)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:AVILA-CAO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S FLOWER ST
Mailing Address - Street 2:UNIT #26
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3447
Mailing Address - Country:US
Mailing Address - Phone:714-623-5766
Mailing Address - Fax:
Practice Address - Street 1:331 S. CITY DR.
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-935-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610247163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse