Provider Demographics
NPI:1679127716
Name:BRIERTON, CRYSTAL ANN (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:BRIERTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:SAN GERONIMO
Mailing Address - State:CA
Mailing Address - Zip Code:94963-0553
Mailing Address - Country:US
Mailing Address - Phone:559-514-2113
Mailing Address - Fax:
Practice Address - Street 1:1350 S ELISEO DR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2011
Practice Address - Country:US
Practice Address - Phone:415-925-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist