Individual
MRS. CRYSTAL PATRESE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15662 K ST, MOJAVE, CA 93501-1826
(661) 824-4118
Mailing address
5783 EDMONDS WAY, MOJAVE, CA 93501-7414
(661) 824-4350
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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