Provider Demographics
NPI:1326747320
Name:YANGAS, CHRISTINA (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:YANGAS
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, LD
Mailing Address - Street 1:2902 W LEMON ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1638
Mailing Address - Country:US
Mailing Address - Phone:612-280-1304
Mailing Address - Fax:
Practice Address - Street 1:2902 W LEMON ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1638
Practice Address - Country:US
Practice Address - Phone:612-280-1304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164008412133V00000X
MN3668133V00000X
GALD006000133V00000X
WI3466-29133V00000X
PADN007515133V00000X
TN4034133V00000X
WADI61226125133V00000X
FL8216133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered