Crystal Ann Phillips, SUDRC-1

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

23113 Issued in CA

Practice address

1400 N Johnson Ave Ste 101
El Cajon, CA 92020-1651

Phone

(619) 440-4801

NPI assigned

Jan 19, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1768780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1013876606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N JOHNSON AVE STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201651",
            "telephone_number": "619-440-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N JOHNSON AVE STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201651",
            "telephone_number": "619-440-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "credential": "SUDRC-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "23113",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "SUDRCI23113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Pricilla Christine Phares
• Pharm-One, Inc.
• Sara Elizabeth Phegley
• Heidi Beth Philips, LCSW
• Christina Phillips, DACM, LAC
• Jennifer Phillips, RN
• Leslie Snow Phillips, D.D.S.
• Skylar Joseph Phillips
• Stephen Elliott Phillips, D.D.S.
• Orrisa Philpot

• Multi-Specialty Clinic/Center in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.