Provider Demographics
NPI:1851928899
Name:KHOURI, YASMIN GABRIELLA
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:GABRIELLA
Last Name:KHOURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 REGATTA CT
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6412
Mailing Address - Country:US
Mailing Address - Phone:530-220-2108
Mailing Address - Fax:
Practice Address - Street 1:2503 REGATTA CT
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-6412
Practice Address - Country:US
Practice Address - Phone:530-220-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program