Provider Demographics
NPI:1720889231
Name:CHUJUTALI, YAINA
Entity type:Individual
Prefix:
First Name:YAINA
Middle Name:
Last Name:CHUJUTALI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25622 MEAD ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2421
Mailing Address - Country:US
Mailing Address - Phone:909-786-5018
Mailing Address - Fax:
Practice Address - Street 1:25622 MEAD ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2421
Practice Address - Country:US
Practice Address - Phone:909-786-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker