Provider Demographics
NPI:1659184810
Name:CROZIER, NIKKITA (PT, DPT)
Entity type:Individual
Prefix:
First Name:NIKKITA
Middle Name:
Last Name:CROZIER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LIPTON WAY
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-4525
Mailing Address - Country:US
Mailing Address - Phone:806-470-1772
Mailing Address - Fax:
Practice Address - Street 1:599 TOMALES RD
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-5002
Practice Address - Country:US
Practice Address - Phone:707-765-7200
Practice Address - Fax:707-765-7521
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
NV4879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171000000XOther Service ProvidersMilitary Health Care Provider