Provider Demographics
NPI:1104152693
Name:NOVAK, YVONNE (CD, CLE, CCCE)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:CD, CLE, CCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 LINDA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-2342
Mailing Address - Country:US
Mailing Address - Phone:626-390-3555
Mailing Address - Fax:
Practice Address - Street 1:1223 LINDA VISTA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103
Practice Address - Country:US
Practice Address - Phone:626-390-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula