Provider Demographics
NPI:1275241119
Name:FLAATEN, GIANNA KRYSTAL (NP-C)
Entity Type:Individual
Prefix:
First Name:GIANNA
Middle Name:KRYSTAL
Last Name:FLAATEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 KROLOP RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-1220
Mailing Address - Country:US
Mailing Address - Phone:408-515-3212
Mailing Address - Fax:
Practice Address - Street 1:3130 CROW CANYON PL STE 180
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1346
Practice Address - Country:US
Practice Address - Phone:925-215-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020792363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner