Provider Demographics
NPI:1811053176
Name:CRAWFORD, CRISTIE KAY (RD, CDE)
Entity type:Individual
Prefix:MISS
First Name:CRISTIE
Middle Name:KAY
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2080 SYLVAN WAY APT 1611
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-4736
Mailing Address - Country:US
Mailing Address - Phone:209-476-5526
Mailing Address - Fax:209-476-3144
Practice Address - Street 1:7373 WEST LN
Practice Address - Street 2:KAISER PERMANENTE, HEALTH EDUCATION
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3377
Practice Address - Country:US
Practice Address - Phone:209-476-5526
Practice Address - Fax:209-476-3144
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered