Provider Demographics
NPI:1811879240
Name:ALCANTARA, YARAH (RN)
Entity type:Individual
Prefix:
First Name:YARAH
Middle Name:
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 WHITING ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3691
Mailing Address - Country:US
Mailing Address - Phone:630-878-1377
Mailing Address - Fax:
Practice Address - Street 1:207 WHITING ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3691
Practice Address - Country:US
Practice Address - Phone:630-878-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ263121163WC0200X
OR202103381RN163WC0200X
IL041472530163WC0200X
DCRN500005366163WC0200X
CA95303691163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine