Individual provider Active NPI

Crystal M. Felice, PHARMD

  • Pharmacist
  • Valley Village, CA
National Provider Identifier
1073041307
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH85408 Issued in CA
Practice address
5657 Laurel Canyon Blvd Apt 202
Valley Village, CA 91607-1870
Phone
(219) 241-4455
NPI assigned
May 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0016283 OR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0016283 OR
Pharmacist 183500000X RPH85408 CA Primary

Addresses

Primary practice location

5657 Laurel Canyon Blvd Apt 202
Valley Village, CA 91607-1870

Mailing address

5657 Laurel Canyon Blvd Apt 202
Valley Village, CA 91607-1870

Other practice location 1

821 S Main St
Myrtle Creek, OR 97457-9334
Phone (541) 863-6383

Other practice location 2

1539 NE Stephens St
Roseburg, OR 97470-1563
Phone (541) 957-2540

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH85408CAMDPharmacist
RPH-0016283ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1073041307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5657 LAUREL CANYON BLVD APT 202",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916071870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5657 LAUREL CANYON BLVD APT 202",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916071870",
            "telephone_number": "219-241-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 S Main St",
            "address_purpose": "LOCATION",
            "city": "Myrtle Creek",
            "state": "OR",
            "postal_code": "974579334",
            "country_code": "US",
            "telephone_number": "541-863-6383",
            "fax_number": "541-863-6023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1539 NE Stephens St",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974701563",
            "country_code": "US",
            "telephone_number": "541-957-2540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELICE",
        "first_name": "CRYSTAL",
        "middle_name": "M.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0016283",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0016283",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH85408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.