Provider Demographics
NPI:1659199164
Name:YEE, IZZA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:IZZA MARIE
Middle Name:
Last Name:YEE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24006 FRIAR ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1238
Mailing Address - Country:US
Mailing Address - Phone:818-917-6768
Mailing Address - Fax:
Practice Address - Street 1:22030 SHERMAN WAY STE 211
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1882
Practice Address - Country:US
Practice Address - Phone:559-231-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily