Healthcare Provider Details

I. General information

NPI: 1598293102
Provider Name (Legal Business Name): CRYSTAL EPIPHANY BABB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E AJO WAY
TUCSON AZ
85713-6204
US

IV. Provider business mailing address

2800 E AJO WAY
TUCSON AZ
85713-6204
US

V. Phone/Fax

Practice location:
  • Phone: 909-632-6728
  • Fax:
Mailing address:
  • Phone: 909-632-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number63703
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: