Individual
CRYSTAL JEAN NICOLE COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4732 DUNDEE ST, ANTIOCH, CA 94531-9449
(925) 421-8429
Mailing address
4732 DUNDEE ST, ANTIOCH, CA 94531-9449
(925) 421-8429
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95029245
CA
Other
Enumeration date
09/18/2015
Last updated
12/03/2015
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