Provider Demographics
NPI:1770320152
Name:LLAMAS, ILDA YOLANDA (RN)
Entity type:Individual
Prefix:MS
First Name:ILDA
Middle Name:YOLANDA
Last Name:LLAMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10211 DAYBREAK LN UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-8440
Mailing Address - Country:US
Mailing Address - Phone:818-517-4547
Mailing Address - Fax:
Practice Address - Street 1:5353 MISSION CENTER RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1305
Practice Address - Country:US
Practice Address - Phone:818-517-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program