Active NPI
Crystal Jade Dea, FNP
- Family Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1407271463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 23203
- Practice address
- 1390 Market St Ste 200
San Francisco, CA 94102-5404 - Phone
- (877) 619-8775
- NPI assigned
- Feb 28, 2014
- Last updated
- Jun 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23203 | CA | Primary |
Addresses
Primary practice location
1390 Market St Ste 200
San Francisco, CA 94102-5404
Mailing address
395 Oyster Point Blvd Ste 512
South San Francisco, CA 94080-1973
Phone (650) 826-2945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23203 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1407271463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 OYSTER POINT BLVD STE 512",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940801973",
"telephone_number": "650-826-2945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 MARKET ST STE 200",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941025404",
"telephone_number": "877-619-8775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEA",
"first_name": "CRYSTAL",
"middle_name": "JADE",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-28",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "23203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.