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Crystal Clark
NPI 1548742141 · on the registry since 2018 · sole proprietor
Practice
- Address
- 840 N Avenue 66
Los Angeles, CA 90042 - Phone
- (310) 404-6112
- Clinicians at this address
- 555
Additional practice sites
- 3850 S Crenshaw Blvd, Los Angeles, CA
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-11-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California