Provider Demographics
NPI:1457882771
Name:YOULESI VENSAN, EMILIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:EMILIN
Middle Name:
Last Name:YOULESI VENSAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:EMILIN
Other - Middle Name:
Other - Last Name:VANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5221 ZELZAH AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5221 ZELZAH AVE APT 110
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2115
Practice Address - Country:US
Practice Address - Phone:818-290-6628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist