Provider Demographics
NPI:1285399261
Name:PARDO, YVETTE ANGELICA (RN)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ANGELICA
Last Name:PARDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 LA PLATA AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5908
Mailing Address - Country:US
Mailing Address - Phone:323-481-8072
Mailing Address - Fax:
Practice Address - Street 1:2805 LA PLATA AVE
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5908
Practice Address - Country:US
Practice Address - Phone:323-481-8072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95238140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse