Provider Demographics
NPI:1700961885
Name:ZIRKLE-YOSHIDA, MICHELLE MARIETTE (FNP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARIETTE
Last Name:ZIRKLE-YOSHIDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:940 DISC DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4544
Mailing Address - Country:US
Mailing Address - Phone:831-430-3030
Mailing Address - Fax:831-460-6389
Practice Address - Street 1:1156 HIGH ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95064-1077
Practice Address - Country:US
Practice Address - Phone:831-594-2500
Practice Address - Fax:831-459-3546
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ50650Medicare UPIN