Provider Demographics
NPI:1356417851
Name:GALVAN, CRYSTAL ANN (DC)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:ANN
Last Name:GALVAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:ANN
Other - Last Name:CLINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:464 VEREDA DEL CIERVO
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117
Mailing Address - Country:US
Mailing Address - Phone:805-284-2257
Mailing Address - Fax:
Practice Address - Street 1:310 PINE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3736
Practice Address - Country:US
Practice Address - Phone:805-687-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor