Provider Demographics
NPI:1528154150
Name:YAMAMOTO, DEANNA DELPHINA (NP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DELPHINA
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:DELPHINA
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:751 S BASCOM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 S BASCOM AVE
Practice Address - Street 2:VHC BASCOM RHEUMATOLOGY CLINIC
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2603
Practice Address - Country:US
Practice Address - Phone:408-885-5973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN385025363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN385025Medicaid
CAZZZ25770ZMedicare PIN
CAP84584Medicare UPIN