Provider Demographics
NPI:1568999738
Name:CRANE, AKILA (MBA)
Entity Type:Individual
Prefix:MISS
First Name:AKILA
Middle Name:
Last Name:CRANE
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52258
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92517-3258
Mailing Address - Country:US
Mailing Address - Phone:951-907-6820
Mailing Address - Fax:
Practice Address - Street 1:4253 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5151
Practice Address - Country:US
Practice Address - Phone:951-907-6820
Practice Address - Fax:951-907-6820
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7667621172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver