Organization
CRESTLINE MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SNIPES MD (OWNER)
(213) 827-3038
Entity
Organization
Contact information
Practice address
325 S 1ST ST STE 200, SAN JOSE, CA 95113-2835
(415) 839-7564
Mailing address
325 S 1ST ST STE 200, SAN JOSE, CA 95113-2835
(415) 839-7564
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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