Provider Demographics
NPI:1649805250
Name:CHRYSOVERGIS, KAREE AKEMI (FNP)
Entity type:Individual
Prefix:
First Name:KAREE
Middle Name:AKEMI
Last Name:CHRYSOVERGIS
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 1:6699 VISTA LOMA
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6413
Mailing Address - Country:US
Mailing Address - Phone:714-743-1718
Mailing Address - Fax:
Practice Address - Street 1:2010 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4079
Practice Address - Country:US
Practice Address - Phone:714-556-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013469207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine