Provider Demographics
NPI:1033461561
Name:BERKHEIMER, CRYSTAL JOY P
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL JOY
Middle Name:P
Last Name:BERKHEIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 ROYAL ESTATES DR
Mailing Address - Street 2:A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-6286
Mailing Address - Country:US
Mailing Address - Phone:702-686-0355
Mailing Address - Fax:
Practice Address - Street 1:1695 ROYAL ESTATES DR
Practice Address - Street 2:A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-6286
Practice Address - Country:US
Practice Address - Phone:702-686-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner