Individual
CRYSTAL S NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
845 FULTON AVE APT 1051, SACRAMENTO, CA 95825-6434
(916) 254-2334
Mailing address
845 FULTON AVE APT 1051, SACRAMENTO, CA 95825-6434
(916) 254-2334
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/29/2020
Last updated
03/20/2020
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