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NPI Code Detail

MEDICARE: KC CRAWFORD

MEDICARE: KC CRAWFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker74680CA
2101YM0800XMental Health Counselor33505CA

General Provider Information

NPI Number : 1093076473
Entity Type Code : Individual
Provider Name (Legal Business Name) : KC CRAWFORD
Provider Business Mailing Address
First Line : 7410 MISSION VALLEY RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4405
Country : US
Telephone Number : 619-497-8989
Fax Number : 858-552-4366
Provider Business Practice Location Address
First Line : 7155 MISSION GORGE RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-1130
Country : US
Telephone Number : 858-300-0460
Fax Number : 858-300-0461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2012
Last Update Date : 04/22/2026

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Directions to “ KC CRAWFORD ” Practice Location

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