Provider Demographics
NPI:1316038581
Name:ANNECONE, KRISTI M (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:M
Last Name:ANNECONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 MOORPARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1840
Mailing Address - Country:US
Mailing Address - Phone:408-243-2700
Mailing Address - Fax:408-553-0750
Practice Address - Street 1:4050 MOORPARK AVENUE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1840
Practice Address - Country:US
Practice Address - Phone:408-243-2700
Practice Address - Fax:408-553-0750
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA490104207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology