Provider Demographics
NPI:1245074616
Name:VELEZ-GOMEZ-EDWARDS, KRYSTAL BRISETTE
Entity type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:BRISETTE
Last Name:VELEZ-GOMEZ-EDWARDS
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 1:2028 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2616
Mailing Address - Country:US
Mailing Address - Phone:510-689-4780
Mailing Address - Fax:
Practice Address - Street 1:2028 10TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-2616
Practice Address - Country:US
Practice Address - Phone:510-689-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2025-01-10
Deactivation Date:2024-06-20
Deactivation Code:
Reactivation Date:2025-01-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula