| Doctor Name: | CRYSTAL CARPENTER |
| NPI Number: | 1003156720 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1160 N Dutton Ave Suite 105 Santa Rosa, CA - 954014600 |
| Business Phone Number: | 7075452700 |
| Business Fax Number: | |
| Mailing Address: | 1160 N Dutton Ave, Suite 105 SANTA ROSA |
| State: | CA |
| Postal Code: | 954014600 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2013 |
| NPI Last Update Date: | 02/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2470A2800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Health Information |
| Taxonomy Specialization: | Assistant Record Technician |
| Taxonomy Definition: | |