Provider Demographics
NPI:1801555743
Name:YASHITA, MISHELE
Entity type:Individual
Prefix:MISS
First Name:MISHELE
Middle Name:
Last Name:YASHITA
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 1:1895 N VIA MIRALESTE UNIT 1519
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3176
Mailing Address - Country:US
Mailing Address - Phone:760-799-6070
Mailing Address - Fax:
Practice Address - Street 1:1895 N VIA MIRALESTE UNIT 1519
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-3176
Practice Address - Country:US
Practice Address - Phone:760-799-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2024-07-10
Deactivation Date:2024-04-15
Deactivation Code:
Reactivation Date:2024-05-30
Provider Licenses
StateLicense IDTaxonomies
CA18015557431835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty