Healthcare Provider Details

I. General information

NPI: 1922523547
Provider Name (Legal Business Name): CHRISTAL YEAGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTAL DEIBER

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 S VAL VISTA DR STE 51085110
MESA AZ
85204-7362
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10456
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: