Healthcare Provider Details

I. General information

NPI: 1194639906
Provider Name (Legal Business Name): RYAN L CREWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1958 UNION ST
SAN FRANCISCO CA
94123-4205
US

IV. Provider business mailing address

7012 LOCKWOOD ST
OAKLAND CA
94621-3130
US

V. Phone/Fax

Practice location:
  • Phone: 415-888-8693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number10433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: