Provider Demographics
NPI:1760707897
Name:MOYA, YANINA LINDA (PA)
Entity Type:Individual
Prefix:
First Name:YANINA
Middle Name:LINDA
Last Name:MOYA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:24805 ALESSANDRO BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-6101
Mailing Address - Country:US
Mailing Address - Phone:951-601-6618
Mailing Address - Fax:
Practice Address - Street 1:24805 ALESSANDRO BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6101
Practice Address - Country:US
Practice Address - Phone:951-601-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 20872363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant