MEDICARE: SARA ELIZABETH CRAWFORD AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN2294386	MA
2	363L00000X	Nurse Practitioner	95038520	CA

General Provider Information

NPI Number	:	1033758503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH CRAWFORD AGACNP-BC

Provider Business Mailing Address
First Line	:	36 ADDINGTON RD
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02445-4628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2438 N PONDEROSA DR STE C105
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-2465
Country	:	US
Telephone Number	:	805-388-2068
Fax Number	:	805-484-7700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2020
Last Update Date	:	03/12/2026

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Directions to “ SARA ELIZABETH CRAWFORD AGACNP-BC” Practice Location

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