Provider Demographics
NPI:1356351753
Name:WEARY, YONG SEDONIA (CNM)
Entity type:Individual
Prefix:
First Name:YONG
Middle Name:SEDONIA
Last Name:WEARY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NA
Mailing Address - Street 1:555 E VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3048
Mailing Address - Country:US
Mailing Address - Phone:760-739-3000
Mailing Address - Fax:
Practice Address - Street 1:555 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3048
Practice Address - Country:US
Practice Address - Phone:760-739-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW625367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife