Provider Demographics
NPI:1467914747
Name:MACIAS-EL YAMANY, LAURA (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MACIAS-EL YAMANY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MACIAS-CASTANON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15071 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-5260
Mailing Address - Country:US
Mailing Address - Phone:562-201-2304
Mailing Address - Fax:
Practice Address - Street 1:21705 MARTIN ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-7316
Practice Address - Country:US
Practice Address - Phone:833-867-4642
Practice Address - Fax:360-462-2751
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9501242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily