Individual
MR. KENNETH CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2150 STOCKTON BLVD, SACRAMENTO, CA 95817-1337
(916) 823-5075
Mailing address
6580 HARMON DR, SACRAMENTO, CA 95831-1950
(916) 743-5264
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT29117
CA
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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