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NPI Code Detail

MEDICARE: MR. NESBIT CRUTCHFIELD

MEDICARE: MR. NESBIT CRUTCHFIELD
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
1101YP2500XProfessional Counselor101YP2500XCA

General Provider Information

NPI Number : 1881740231
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NESBIT CRUTCHFIELD
Provider Business Mailing Address
First Line : 100 EDDY ST APT 4
Second Line :
City : POINT RICHMOND
State : CA
Zip : 94801-3886
Country : US
Telephone Number : 510-704-1347
Fax Number :
Provider Business Practice Location Address
First Line : 280 17TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94612-4124
Country : US
Telephone Number : 510-238-5020
Fax Number : 510-261-3584
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ MR. NESBIT CRUTCHFIELD ” Practice Location

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