Provider Demographics
NPI:1255838603
Name:L'HERAUX, CRYSTINE (NP-C)
Entity type:Individual
Prefix:
First Name:CRYSTINE
Middle Name:
Last Name:L'HERAUX
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 VERNA WAY
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-8593
Mailing Address - Country:US
Mailing Address - Phone:925-338-0448
Mailing Address - Fax:840-400-1020
Practice Address - Street 1:3249 MT DIABLO CT STE 206
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4049
Practice Address - Country:US
Practice Address - Phone:925-338-0448
Practice Address - Fax:840-400-1020
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008699363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care