Provider Demographics
NPI:1518086388
Name:FERMIL, YVONNE DECASTRO (FNP)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:DECASTRO
Last Name:FERMIL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:DECASTRO
Other - Last Name:FERMIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:292 EUCLID AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-3629
Mailing Address - Country:US
Mailing Address - Phone:619-266-3332
Mailing Address - Fax:
Practice Address - Street 1:292 EUCLID AVE STE 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3629
Practice Address - Country:US
Practice Address - Phone:619-266-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN525830163W00000X
CA11786207Q00000X
CAFNP11786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine