Provider Demographics
NPI:1508648429
Name:CRAWFORD, CIANA S
Entity Type:Individual
Prefix:
First Name:CIANA
Middle Name:S
Last Name:CRAWFORD
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 1:11518 OBERT AVE APT 12A
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2812
Mailing Address - Country:US
Mailing Address - Phone:562-341-0791
Mailing Address - Fax:
Practice Address - Street 1:11518 OBERT AVE APT 12A
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2812
Practice Address - Country:US
Practice Address - Phone:562-341-0791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician