Provider Demographics
NPI:1669731915
Name:YEATTS, ROSALINDA (MT)
Entity type:Individual
Prefix:MS
First Name:ROSALINDA
Middle Name:
Last Name:YEATTS
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11177 TAMPA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2254
Mailing Address - Country:US
Mailing Address - Phone:818-831-8000
Mailing Address - Fax:818-831-8005
Practice Address - Street 1:11177 TAMPA AVE
Practice Address - Street 2:STE A
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2254
Practice Address - Country:US
Practice Address - Phone:818-831-8000
Practice Address - Fax:818-831-8005
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist