Individual
NADINE H YASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
991 RESERVE DRIVE, SUITE A, ROSEVILLE, CA 95678-1340
(916) 789-8811
(916) 789-8809
Mailing address
991 RESERVE DRIVE, SUITE A, ROSEVILLE, CA 95678-1340
(916) 789-8811
(916) 789-8809
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
A48720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A487201
—
CA
01
—
00A487202
MEDICARE PTAN - INDIVIDUAL
CA
01
—
CGP159990
MEDICAID CCS PROVIDER NUMBER
CA
01
—
P00190174
RAILROAD MEDICARE
—
Enumeration date
11/16/2005
Last updated
01/11/2013
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