Individual
MRS. CRYSTAL BLEU STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6091 WINTERGREEN DR, HUNTINGTON BEACH, CA 92647-6463
(714) 496-2299
(866) 274-0162
Mailing address
6091 WINTERGREEN DR, HUNTINGTON BEACH, CA 92647-6463
(714) 496-2299
(866) 274-0162
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT6542
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0065420
BLUE SHIELD
CA
Enumeration date
12/10/2009
Last updated
12/10/2009
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