Provider Demographics
NPI:1295598019
Name:GRACIA, YANELI N
Entity type:Individual
Prefix:
First Name:YANELI
Middle Name:N
Last Name:GRACIA
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 1:11205 EFADA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6388
Mailing Address - Country:US
Mailing Address - Phone:805-863-7477
Mailing Address - Fax:
Practice Address - Street 1:11205 EFADA DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6388
Practice Address - Country:US
Practice Address - Phone:805-863-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program