Provider Demographics
NPI:1871104737
Name:YUTUC, ABIGAIL JOY CAYANAN
Entity type:Individual
Prefix:
First Name:ABIGAIL JOY
Middle Name:CAYANAN
Last Name:YUTUC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 EVELYN CIR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-1864
Mailing Address - Country:US
Mailing Address - Phone:707-656-1350
Mailing Address - Fax:
Practice Address - Street 1:165 EVELYN CIR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-1864
Practice Address - Country:US
Practice Address - Phone:707-656-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA707938164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse