Provider Demographics
NPI:1013699974
Name:GEDAM, YOHANA
Entity Type:Individual
Prefix:
First Name:YOHANA
Middle Name:
Last Name:GEDAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 S 5TH ST APT 354
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5970
Mailing Address - Country:US
Mailing Address - Phone:408-355-8609
Mailing Address - Fax:
Practice Address - Street 1:868 S 5TH ST APT 354
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5970
Practice Address - Country:US
Practice Address - Phone:408-355-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient Transport