Provider Demographics
NPI:1972149870
Name:CREWS, PAUL JAY
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JAY
Last Name:CREWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 EDITH LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-6703
Mailing Address - Country:US
Mailing Address - Phone:661-431-3408
Mailing Address - Fax:661-834-2340
Practice Address - Street 1:1001 MEREDITH DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-6123
Practice Address - Country:US
Practice Address - Phone:661-397-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator