Provider Demographics
NPI:1235261306
Name:YAP, DISAN FLORES (APRN, BC)
Entity Type:Individual
Prefix:MISS
First Name:DISAN
Middle Name:FLORES
Last Name:YAP
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1015
Mailing Address - Country:US
Mailing Address - Phone:510-364-7374
Mailing Address - Fax:209-839-0119
Practice Address - Street 1:431 E LEGACY DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95391-1015
Practice Address - Country:US
Practice Address - Phone:510-364-7374
Practice Address - Fax:209-839-0119
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner