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Individual

MRS. CRYSTAL ANNE BRUST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5367
Mailing address
9351 OX BOW LN, LOOMIS, CA 95650-8841
(530) 864-0078

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
20824
CA
363AS0400X
Surgical Physician Assistant
Primary
20824
CA

Other

Enumeration date
02/08/2010
Last updated
02/11/2022
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