Provider Demographics
NPI:1821225319
Name:ALPERT, CRYSTAL ROSE SOPHIA (PA-C)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ROSE SOPHIA
Last Name:ALPERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TAMPICO
Mailing Address - Street 2:STE 210
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2962
Mailing Address - Country:US
Mailing Address - Phone:925-935-6952
Mailing Address - Fax:
Practice Address - Street 1:2481 PACHECO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2019
Practice Address - Country:US
Practice Address - Phone:925-680-8933
Practice Address - Fax:925-680-7635
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20344363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH38774Medicare UPIN