LAURENCE NIKKO CRISOSTOMO NP
NPI 1760979637
Nurse Practitioner - Family in Elk Grove, CA
Active since April 17, 2018
About Laurence Nikko Crisostomo Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAURENCE NIKKO CRISOSTOMO NP (NPI 1760979637) is an individual family provider in Elk Grove, California, licensed in California (NP95005664) and active in the NPI registry since April 2018.
NPPES Registry Identity
NPI1760979637
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameLAURENCE NIKKO CRISOSTOMOCredential: NP
Location Address6617 TRONZANO WAYElk Grove, CA 95757-3057
Mailing Address89 Lincoln Blvd Ste 100Lincoln, CA 95648-8096 · (916) 543-1593 · Fax (877) 466-7829
Phone(916) 627-6663
Sole ProprietorYes
Enumeration DateApril 17, 2018
✔ NPI 1760979637 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · NP95005664
6617 TRONZANO WAY, Elk Grove, CA 95757
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760979637, enumerated as an "individual" on April 17, 2018.
The provider is located at 6617 TRONZANO WAY ELK GROVE, CA 95757 and the phone number is (916) 627-6663.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
