Provider Demographics
NPI:1063066546
Name:PINK BROWN, YASHEIKA (BSN, RN, PHN)
Entity type:Individual
Prefix:MS
First Name:YASHEIKA
Middle Name:
Last Name:PINK BROWN
Suffix:
Gender:
Credentials:BSN, RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8663
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-8663
Mailing Address - Country:US
Mailing Address - Phone:323-978-3624
Mailing Address - Fax:
Practice Address - Street 1:5051 W AVENUE M4
Practice Address - Street 2:
Practice Address - City:QUARTZ HILL
Practice Address - State:CA
Practice Address - Zip Code:93536-3030
Practice Address - Country:US
Practice Address - Phone:323-978-3624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285614164X00000X
CA95396598163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse