Individual provider Active NPI

Yetunde Ligali

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1053133595
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95032849 Issued in CA
Practice address
710 N Euclid St Ste 208
Anaheim, CA 92801-4132
Phone
(817) 608-7361
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1053145 TX
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 95032849 CA Primary

Addresses

Primary practice location

710 N Euclid St Ste 208
Anaheim, CA 92801-4132

Mailing address

710 N Euclid St Ste 208
Anaheim, CA 92801-4132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805003591 CA Practitioner - Nurse Practitioner 1456869965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1053145TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. Single Specialty CurrentSince Jul 1, 2025 Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

5125 Skyway
Paradise, CA 95969
Phone (530) 872-2000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1053133595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 208",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 208",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014132",
            "telephone_number": "817-608-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGALI",
        "first_name": "YETUNDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1053145",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95032849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.