Krystle Rose Frazier, ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY31885 Issued in CA

Practice address

9600 Center Ave Ste 160
Rancho Cucamonga, CA 91730-5838

Phone

(800) 434-8923

NPI assigned

Sep 18, 2017

Last updated

Mar 27, 2025By the provider in NPPES

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

• Dr. Krystle Rose Frazier Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1073032389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 CENTER AVE STE 160",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305838",
            "telephone_number": "800-434-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 CENTER AVE STE 160",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305838",
            "telephone_number": "800-434-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "KRYSTLE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "FRAZIER",
            "middle_name": "ROSE",
            "prefix": "DR.",
            "credential": "ED.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.