Healthcare Provider Details

I. General information

NPI: 1194185397
Provider Name (Legal Business Name): PEGGY M EINSELE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 S OREGON ST
YREKA CA
96097-3425
US

IV. Provider business mailing address

PO BOX 211
GRENADA CA
96038-0211
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-9200
  • Fax: 530-842-9207
Mailing address:
  • Phone: 530-864-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: