Provider Demographics
NPI:1366195414
Name:TRISTIE YUMUL-GOCE
Entity type:Organization
Organization Name:TRISTIE YUMUL-GOCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:TRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YUMUL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:818-438-8777
Mailing Address - Street 1:21036 COSTANSO ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2204
Mailing Address - Country:US
Mailing Address - Phone:818-438-8777
Mailing Address - Fax:
Practice Address - Street 1:325 ROLLING OAKS DR STE 110
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1299
Practice Address - Country:US
Practice Address - Phone:818-461-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty