Provider Demographics
NPI:1609699529
Name:LEDESMA, YASMIN (RN)
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:LEDESMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 SHASTA ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-4847
Mailing Address - Country:US
Mailing Address - Phone:510-274-0628
Mailing Address - Fax:
Practice Address - Street 1:10345 PROFESSIONAL CIR STE 125
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-3100
Practice Address - Country:US
Practice Address - Phone:775-348-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95393944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse