Provider Demographics
NPI:1003663071
Name:CROSBY, CHRISTINA MARIE
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CROSBY
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 1:5077 PRYOR DR
Mailing Address - Street 2:
Mailing Address - City:RESCUE
Mailing Address - State:CA
Mailing Address - Zip Code:95672-9590
Mailing Address - Country:US
Mailing Address - Phone:916-301-3740
Mailing Address - Fax:
Practice Address - Street 1:1160 SUNCAST LN STE 7
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9327
Practice Address - Country:US
Practice Address - Phone:916-301-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty