Provider Demographics
NPI:1992141105
Name:CRAWFORD, WENDY RENE
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:RENE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40165 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:I
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6434
Mailing Address - Country:US
Mailing Address - Phone:951-461-1800
Mailing Address - Fax:
Practice Address - Street 1:40165 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:I
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6434
Practice Address - Country:US
Practice Address - Phone:951-461-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor