Provider Demographics
NPI:1679863831
Name:MCCRIMMON, MAJESTIQUE
Entity Type:Individual
Prefix:
First Name:MAJESTIQUE
Middle Name:
Last Name:MCCRIMMON
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 1:19300 RINALDI ST
Mailing Address - Street 2:8270
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1651
Mailing Address - Country:US
Mailing Address - Phone:562-343-5800
Mailing Address - Fax:
Practice Address - Street 1:19300 RINALDI ST
Practice Address - Street 2:8270
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-1651
Practice Address - Country:US
Practice Address - Phone:562-343-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor