Individual
YASAMAN ASHLEY LAJEVARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 443-2682
(559) 443-2681
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
60508
CA
363AS0400X
Surgical Physician Assistant
Primary
60508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96158097A9
—
CA
Enumeration date
04/02/2020
Last updated
07/17/2023
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