Provider Demographics
NPI:1306638184
Name:YESCAS, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:YESCAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PLACITA FARA
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-7605
Mailing Address - Country:US
Mailing Address - Phone:520-501-9242
Mailing Address - Fax:
Practice Address - Street 1:8742 E VICKSBURG ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2915
Practice Address - Country:US
Practice Address - Phone:520-207-0679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL13327H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility