Crystal Marie Makasarashvili

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95030716 Issued in CA

Practice address

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

Phone

(408) 284-2280

NPI assigned

Jul 16, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Crystal Marie Garcia Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: cmakasarashvili693309@hisp.ehr.sutterhealth.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1831937895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WAINWRIGHT AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 VIA DEL ORO STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191372",
            "telephone_number": "408-284-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKASARASHVILI",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95030716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "GARCIA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassandra Koren Majus, MFT
• Michele Wing-Sze Mak-Fung, M.D.
• Nirav H Makadia, PHARM D
• Meghana Makani, DPT
• Ranjit Singh Makar, MD
• Richika Makol, MD
• Natally Malagon Gonzalez
• Guadalupe Malagon
• Kasturi Malaviya, DO
• Miriam Maldavsky, LCSW

• Pediatric Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.