Provider Demographics
NPI:1841054400
Name:VAHER, EMMA RAE (FNP)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:RAE
Last Name:VAHER
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:ROOTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-9158
Mailing Address - Country:US
Mailing Address - Phone:209-674-6182
Mailing Address - Fax:
Practice Address - Street 1:305 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9158
Practice Address - Country:US
Practice Address - Phone:209-674-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029063363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily