Individual
MRS. CRYSTAL RENE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
144 W LOS ANGELES AVE, STE 110, MOORPARK, CA 93021-1898
(805) 552-1915
(805) 552-1991
Mailing address
144 W LOS ANGELES AVE, STE 110, MOORPARK, CA 93021-1898
(805) 552-1915
(805) 552-1991
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT32707
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT32707
PT LICENSE
CA
Enumeration date
03/25/2008
Last updated
04/02/2014
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