Provider Demographics
NPI:1316233596
Name:TASTET, KRISTIN NICOLE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:NICOLE
Last Name:TASTET
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:NICOLE
Other - Last Name:TASTET STAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3000 HANOVER ST BLDG 20
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1112
Mailing Address - Country:US
Mailing Address - Phone:650-319-1080
Mailing Address - Fax:650-319-0889
Practice Address - Street 1:3000 HANOVER ST BLDG 20
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1112
Practice Address - Country:US
Practice Address - Phone:650-319-1080
Practice Address - Fax:650-319-0889
Is Sole Proprietor?:No
Enumeration Date:2011-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily