Organization
CRYSTAL PATH WELLNESS NURSING CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATEEFAT TIWALADE ADELE (OWNER)
(813) 494-4476
Entity
Organization
Contact information
Practice address
4010 TRUXEL RD STE 170, SACRAMENTO, CA 95834-3795
(813) 494-4476
Mailing address
4010 TRUXEL RD STE 170, SACRAMENTO, CA 95834-3795
(813) 494-4476
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/21/2026
Last updated
02/21/2026
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