Active NPI
Yola Fawaz
- Chiropractor
- Upland, CA
National Provider Identifier
1043959786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 26280
- Practice address
- 167 N 3Rd Ave Ste R
Upland, CA 91786-6052 - Phone
- (818) 824-2362
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 26280 | CA | Primary |
Addresses
Primary practice location
167 N 3Rd Ave Ste R
Upland, CA 91786-6052
Mailing address
167 N 3Rd Ave Ste R
Upland, CA 91786-6052
Phone (818) 824-2362
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90775518G21244 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1043959786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 N 3RD AVE STE R",
"city": "UPLAND",
"state": "CA",
"postal_code": "917866052",
"telephone_number": "818-824-2362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 N 3RD AVE STE R",
"city": "UPLAND",
"state": "CA",
"postal_code": "917866052",
"telephone_number": "818-824-2362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWAZ",
"first_name": "YOLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "26280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90775518G21244",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.