Healthcare Provider Details

I. General information

NPI: 1003330143
Provider Name (Legal Business Name): CHRYSTAL LYNNE JONES RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

1200 N. STATE ST.
LOS ANGELES CA
90033
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-1000
  • Fax:
Mailing address:
  • Phone: 323-409-7928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number19863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: