Yolanda Matayoshi Carrera, MD
Individual provider Active NPI Pediatrics Physician · Harmon, GU
NPI 1982829016 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982829016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- M000768 (GU)
- Practice address
- 1757 Route 16
Suite 109
Harmon, GU 96929 - Phone
- (671) 649-1058
- Fax
- (671) 649-1057
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M000768 | GU | Yes |
Addresses
Primary practice location
1757 Route 16
Suite 109
Harmon, GU 96929
Mailing address
1757 Route 16
Suite 109
Harmon, GU 96929
Phone (671) 649-1058
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055 | Medicaid | GU |
Other providers in Harmon, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.