Individual
MARY KAY CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
28999 OLD TOWN FRONT ST STE 101, TEMECULA, CA 92590-2842
(951) 261-8392
Mailing address
2245 SERENA HILLS DR, RAMONA, CA 92065-3636
(760) 315-1655
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
449175
CA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
449175
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9991
CAPROVIDERID
CA
Enumeration date
01/30/2007
Last updated
04/10/2025
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