Provider Demographics
NPI:1215280516
Name:YAGO, CAREME (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CAREME
Middle Name:
Last Name:YAGO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 VIRIDIAN TER
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770-6040
Mailing Address - Country:US
Mailing Address - Phone:240-839-8270
Mailing Address - Fax:
Practice Address - Street 1:3611 BRANCH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1242
Practice Address - Country:US
Practice Address - Phone:240-839-8270
Practice Address - Fax:301-355-7828
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224538363LP0808X
DC62407390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program