CRYSTAL MARIE MAKASARASHVILI

SAN JOSE, CA
NPI1831937895
Former NameCRYSTAL MARIE GARCIA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: CA  95030716)
Enumeration Date2024-07-16
Last Update Date2025-02-25
Business Address
CRYSTAL MARIE MAKASARASHVILI
1071 BLOSSOM HILL RD
SAN JOSE, CA 95123-1105
Phone number: 408-445-4020
Mailing Address
CRYSTAL MARIE MAKASARASHVILI
450 WAINWRIGHT AVE
SAN JOSE, CA 95128-2163
Phone number: