Basic Information
| Provider Information | |||||||||
| NPI: | 1992150791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VALDOVINOS- PERDOMO | ||||||||
| FirstName: | HAYDEE | ||||||||
| MiddleName: | YVETTE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5427 WHITTIER BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900224101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238691900 | ||||||||
| FaxNumber: | 3238695362 | ||||||||
| Practice Location | |||||||||
| Address1: | 5427 WHITTIER BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900224101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238691900 | ||||||||
| FaxNumber: | 3238695362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2016 | ||||||||
| LastUpdateDate: | 12/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 95003554 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.