Provider Demographics
NPI:1922180041
Name:MANTELL, CRISTINA S (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:S
Last Name:MANTELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:CRISTINA
Other - Middle Name:S
Other - Last Name:SPRAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4003
Mailing Address - Country:US
Mailing Address - Phone:415-503-6000
Mailing Address - Fax:415-503-6097
Practice Address - Street 1:229 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4003
Practice Address - Country:US
Practice Address - Phone:415-503-6000
Practice Address - Fax:415-503-6097
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily