Provider Demographics
NPI:1356173173
Name:PATLIS, YANA (FNP-C)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:PATLIS
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 1:31437 CULBERTSON LN
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-7911
Mailing Address - Country:US
Mailing Address - Phone:951-216-1764
Mailing Address - Fax:
Practice Address - Street 1:31437 CULBERTSON LN
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-7911
Practice Address - Country:US
Practice Address - Phone:951-216-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95031290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily