Healthcare Provider Details

I. General information

NPI: 1336061100
Provider Name (Legal Business Name): SHAYLYN MAE CRANDALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8335 WILLOW TREE WAY
CITRUS HEIGHTS CA
95621-1156
US

IV. Provider business mailing address

8335 WILLOW TREE WAY
CITRUS HEIGHTS CA
95621-1156
US

V. Phone/Fax

Practice location:
  • Phone: 916-380-0150
  • Fax: 916-380-0150
Mailing address:
  • Phone: 916-380-0150
  • Fax: 916-380-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberCSPD-FULL-1784236625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: