Provider Demographics
NPI:1871071589
Name:YANDELL, KATALINA ASHE ROWLAND (OD)
Entity type:Individual
Prefix:
First Name:KATALINA
Middle Name:ASHE ROWLAND
Last Name:YANDELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 LUNDY AVE UNIT 612899
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95161-7117
Mailing Address - Country:US
Mailing Address - Phone:425-445-6120
Mailing Address - Fax:425-445-6120
Practice Address - Street 1:194 HILLSDALE SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-3409
Practice Address - Country:US
Practice Address - Phone:650-341-8080
Practice Address - Fax:650-341-8565
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34040TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist