Provider Demographics
NPI:1891561213
Name:LERMA, REBEKKA YVETTE (FNP)
Entity type:Individual
Prefix:
First Name:REBEKKA
Middle Name:YVETTE
Last Name:LERMA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 WEST ATEN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9805
Mailing Address - Country:US
Mailing Address - Phone:760-355-7730
Mailing Address - Fax:
Practice Address - Street 1:1665 SOUTH IMPERIAL AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4247
Practice Address - Country:US
Practice Address - Phone:760-592-4783
Practice Address - Fax:760-545-0256
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95027744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily