Provider Demographics
NPI:1285153320
Name:SOSA-VILLATORO, YASMIN ELIZABETH
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:ELIZABETH
Last Name:SOSA-VILLATORO
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 1:4700 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4532
Mailing Address - Country:US
Mailing Address - Phone:301-728-0456
Mailing Address - Fax:
Practice Address - Street 1:4700 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4532
Practice Address - Country:US
Practice Address - Phone:301-728-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC2918377OtherI.D
DC70838828Medicaid