NPIMap

Individual provider Active NPI

Crystal Alvarez Perez

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1073940292
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6529 Issued in CA
Practice address
4411 N Cedar Ave Ste 108
Fresno, CA 93726-2538
Phone
(559) 248-1548
Fax
(559) 248-1530
NPI assigned
Oct 2, 2013
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6529 CA Primary

Addresses

Primary practice location

4411 N Cedar Ave Ste 108
Fresno, CA 93726-2538

Mailing address

4411 N Cedar Ave Ste 108
Fresno, CA 93726-2538
Phone (559) 248-1548

Other identifiers 1

IdentifierTypeStateIssuer
1962637512OtherCAMEDI CAL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Big Picture High School Past Accepting new patients
Dunamis, Inc. Group Home Past Accepting new patients
Kermit Koontz Education Center Past Accepting new patients
Tehipite Middle School Past Accepting new patients
Fort Miller Middle School Past Accepting new patients
Hoover High School Past Accepting new patients
Gateway High Schol Past Accepting new patients
Gaston Middle School Past Accepting new patients
Fresno High School Past Accepting new patients

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1073940292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 N CEDAR AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937262538",
            "telephone_number": "559-248-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N CEDAR AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937262538",
            "telephone_number": "559-248-1548",
            "fax_number": "559-248-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CRYSTAL",
        "middle_name": "ALVAREZ",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "6529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "1962637512",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.