Individual
MISS CRYSTAL JADE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, CES
Contact information
Practice address
500 EL CAMINO REAL, SANTA CLARA, CA 95050-4345
(408) 551-3193
Mailing address
4343 SHORT HILL RD, OAKLAND, CA 94605-4646
(510) 289-9240
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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