Provider Demographics
NPI:1013742980
Name:REPKINA, YULIA
Entity type:Individual
Prefix:
First Name:YULIA
Middle Name:
Last Name:REPKINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24235 AVENIDA DE LAS FLORES
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3521
Mailing Address - Country:US
Mailing Address - Phone:949-338-8970
Mailing Address - Fax:
Practice Address - Street 1:24235 AVENIDA DE LAS FLORES
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3521
Practice Address - Country:US
Practice Address - Phone:949-338-8970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95030736363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care