Provider Demographics
NPI:1619542776
Name:CRAWFORD, STACY LEIGH
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LEIGH
Last Name:CRAWFORD
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 1:301 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5610
Mailing Address - Country:US
Mailing Address - Phone:661-852-5732
Mailing Address - Fax:661-852-5737
Practice Address - Street 1:301 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5610
Practice Address - Country:US
Practice Address - Phone:661-852-5732
Practice Address - Fax:661-852-5737
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator