Active NPI
Crystal M. Felice, PHARMD
- Pharmacist
- Valley Village, CA
National Provider Identifier
1073041307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH85408
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH85408 | CA | MD | Pharmacist |
| RPH-0016283 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
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.