Yacenia Crisostomo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61155013 Issued in WA

Practice address

1305 Tacoma Ave S Ste 201
Tacoma, WA 98402-1903

Phone

(253) 396-5823

NPI assigned

Apr 30, 2021

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Mental Health Center of Tacoma-Pierce County

  • Community/Behavioral Health Agency
  • Tacoma, WA
  • NPI 1952597056
  NPD (past)

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620518400000",
    "number": "1023691615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N 16TH ST STE 316",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061266",
            "telephone_number": "602-650-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 TACOMA AVE S STE 201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021903",
            "telephone_number": "253-396-5823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Freeman Rd E",
            "address_purpose": "LOCATION",
            "city": "Fife",
            "state": "WA",
            "postal_code": "984243776",
            "country_code": "US",
            "telephone_number": "253-942-5644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISOSTOMO",
        "first_name": "YACENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-05-09",
        "certification_date": "2021-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61155013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Crews, R.N.
• Lieu Crews
• Theodore Crisostomo-Wynne, MD
• Brianna Keri Crisostomo
• Dawnrene' Crisostomo, RN
• Paris Crispin
• Critical Time Intervention Pierce County
• Charles Watson Croasdill, DMD
• Vera G Croce, MA, LMHC
• Linda Winston Crockett, ARNP

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2021; 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.