Individual
MRS. CRYSTAL MICHELLE THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7160 BROCKTON AVE FL 2, RIVERSIDE, CA 92506-2614
(951) 782-3821
(951) 328-9758
Mailing address
1089 TREADWELL AVE, SIMI VALLEY, CA 93065-5039
(805) 304-6018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60380
CA
Other
Enumeration date
12/16/2021
Last updated
03/09/2026
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