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Individual

CRYSTAL EZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
2505 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 524-9401
Mailing address
1201 S 7TH AVE STE 150, PHOENIX, AZ 85007-4075

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
237818
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
237818
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95033110
CA

Other

Enumeration date
10/29/2024
Last updated
03/10/2025
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