Individual
YANISET DELIA LASTRA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12228 RAMONA AVE, HAWTHORNE, CA 90250-3630
(424) 285-9222
Mailing address
12228 RAMONA AVE, HAWTHORNE, CA 90250-3630
(310) 644-0751
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
863760
NV
390200000X
Student in an Organized Health Care Education/Training Program
95102028
CA
Other
Enumeration date
06/26/2021
Last updated
01/29/2023
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