Provider Demographics
NPI:1659118065
Name:HERRERA, ANDREA MARIE YUKIO
Entity type:Individual
Prefix:
First Name:ANDREA MARIE
Middle Name:YUKIO
Last Name:HERRERA
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 1:3063 W CHAPMAN AVE APT 4204
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1754
Mailing Address - Country:US
Mailing Address - Phone:626-267-4199
Mailing Address - Fax:
Practice Address - Street 1:3063 W CHAPMAN AVE APT 4204
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1754
Practice Address - Country:US
Practice Address - Phone:626-267-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95349216163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95349216OtherBOARD OF REGISTERED NURSING