Active NPI
Nichelle Crawford
- Prosthetic/Orthotic Supplier
- Corona, CA
National Provider Identifier
1629966767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Practice address
- 2621 Green River Road
#105-2106
Corona, CA 92882-7454 - Phone
- (951) 264-0901
- NPI assigned
- Jun 26, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
2621 Green River Road
#105-2106
Corona, CA 92882-7454
Mailing address
2621 Green River Road
#105-2106
Corona, CA 92882-7454
Phone (951) 264-0901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1629966767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2621 GREEN RIVER ROAD",
"address_2": "#105-2106",
"city": "CORONA",
"state": "CA",
"postal_code": "928827454",
"telephone_number": "951-264-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2621 GREEN RIVER ROAD",
"address_2": "#105-2106",
"city": "CORONA",
"state": "CA",
"postal_code": "928827454",
"telephone_number": "951-264-0901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "NICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-26",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.