Individual provider · Type 1 NPI

Crystal Marie Makasarashvili

Pediatric Nurse Practitioner · San Jose, CA

NPI number 1831937895 Active

Practice location

6840 Via Del Oro Ste 210
San Jose, CA 95119-1372

Mailing address

450 Wainwright Ave
San Jose, CA 95128-2163

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X95030716 (CA)

Pediatric Nurse Practitioner: Definition to come...

10 other providers at this address

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About NPI 1831937895

Crystal Marie Makasarashvili's National Provider Identifier is 1831937895, issued on Jul 16, 2024. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in San Jose, CA. The record was last updated on Jan 13, 2026.