Provider Demographics
NPI:1649750340
Name:JORAT, YASAMIN
Entity type:Individual
Prefix:
First Name:YASAMIN
Middle Name:
Last Name:JORAT
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 1:51 VIA HONRADO
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-1956
Mailing Address - Country:US
Mailing Address - Phone:949-247-6998
Mailing Address - Fax:
Practice Address - Street 1:912 FREMONT ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2713
Practice Address - Country:US
Practice Address - Phone:866-707-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist