Provider Demographics
NPI:1861051997
Name:TULLOCH, YVONNE (RCSN)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:
Last Name:TULLOCH
Suffix:
Gender:F
Credentials:RCSN
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCSN
Mailing Address - Street 1:1301 N A ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-3516
Mailing Address - Country:US
Mailing Address - Phone:805-742-3301
Mailing Address - Fax:
Practice Address - Street 1:1301 N A ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-3516
Practice Address - Country:US
Practice Address - Phone:805-742-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA446952163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool