Provider Demographics
NPI:1790360659
Name:YANEZ, PAOLA L (FNP-C)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:L
Last Name:YANEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 GUIDERA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-5114
Mailing Address - Country:US
Mailing Address - Phone:951-212-2904
Mailing Address - Fax:
Practice Address - Street 1:3607 TROUSDALE PKWY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-3609
Practice Address - Country:US
Practice Address - Phone:844-487-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily