Healthcare Provider Details

I. General information

NPI: 1699061663
Provider Name (Legal Business Name): SANA CHRYSTAL N.D., D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 BLOSSOM HILL RD SUITE B
LOS GATOS CA
95032-3583
US

IV. Provider business mailing address

751 BLOSSOM HILL RD SUITE B
LOS GATOS CA
95032-3583
US

V. Phone/Fax

Practice location:
  • Phone: 480-761-6781
  • Fax:
Mailing address:
  • Phone: 480-761-6178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number484
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: