Individual
MISS EIVOR YANA FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12510 VAN NUYS BLVD., SYLMAR, CA 91331
(818) 899-2532
Mailing address
12510 VAN NUYS BLVD., SYLMAR, CA 91331
(818) 899-2532
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
05/19/2025
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