Provider Demographics
NPI:1316060775
Name:CRAWFORD, CHRISTINA MICHELE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELE
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MICHELE
Other - Last Name:UR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1100 W TOWN AND COUNTRY RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4698
Mailing Address - Country:US
Mailing Address - Phone:657-348-1943
Mailing Address - Fax:714-202-4502
Practice Address - Street 1:1100 W TOWN AND COUNTRY RD STE 1600
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4698
Practice Address - Country:US
Practice Address - Phone:657-348-1943
Practice Address - Fax:714-202-4502
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16656363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA16656OtherPHYSICIAN ASSISTANT LICEN
CAPA16656OtherPHYSICIAN ASSISTANT LICEN