Provider Demographics
NPI:1134767593
Name:LOUCEL, CRYSTAL MELODY (RN)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MELODY
Last Name:LOUCEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MELODY
Other - Last Name:ACUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 21ST AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4448
Mailing Address - Country:US
Mailing Address - Phone:949-892-9231
Mailing Address - Fax:
Practice Address - Street 1:1801 21ST AVE APT 102
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4448
Practice Address - Country:US
Practice Address - Phone:949-892-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA824984163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty