Provider Demographics
NPI:1427512458
Name:HO, ELIZABETH YASIAN (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:YASIAN
Last Name:HO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W HOSPITALITY LN # 324
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3249
Mailing Address - Country:US
Mailing Address - Phone:800-951-9813
Mailing Address - Fax:909-571-6806
Practice Address - Street 1:275 W HOSPITALITY LN # 324
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3249
Practice Address - Country:US
Practice Address - Phone:800-951-9813
Practice Address - Fax:909-571-6806
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235650516Medicaid