Provider Demographics
NPI:1750825212
Name:PACHECO, YANIRA LETICIA (NP)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:LETICIA
Last Name:PACHECO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-9343
Mailing Address - Country:US
Mailing Address - Phone:559-393-8521
Mailing Address - Fax:
Practice Address - Street 1:550 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2096
Practice Address - Country:US
Practice Address - Phone:559-637-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily