Provider Demographics
NPI:1316509888
Name:DE LA CRUZ DE LOS SANTOS, YARIANNE
Entity type:Individual
Prefix:
First Name:YARIANNE
Middle Name:
Last Name:DE LA CRUZ DE LOS SANTOS
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 1:19447 GRAND COLONY CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4541
Mailing Address - Country:US
Mailing Address - Phone:713-427-2908
Mailing Address - Fax:
Practice Address - Street 1:19447 GRAND COLONY CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-4541
Practice Address - Country:US
Practice Address - Phone:713-427-2908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX972603163WP0200X, 163WH0200X
TX219677163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherHOME HEALTH