Provider Demographics
NPI:1932796422
Name:KERN, ERIKO YUTANI (PA)
Entity type:Individual
Prefix:
First Name:ERIKO
Middle Name:YUTANI
Last Name:KERN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 CRETAN BLUE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7470
Mailing Address - Country:US
Mailing Address - Phone:702-408-5785
Mailing Address - Fax:
Practice Address - Street 1:9432 KATY FWY # 460
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6349
Practice Address - Country:US
Practice Address - Phone:832-699-7922
Practice Address - Fax:832-780-5341
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17887363A00000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant