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Individual

YOGGIE EFENDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1430 E COOLEY DR STE 122, COLTON, CA 92324-3944
(909) 572-6226
Mailing address
415 EAST AVENUE I, LANCASTER, CA 93535-2432
(661) 522-6770

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95001545
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95001545
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
95001545
CA
Enumeration date
01/09/2015
Last updated
03/28/2023
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