Individual provider Active NPI

Crystal Adilene Yanez

  • Licensed Psychiatric Technician
  • Anaheim, CA
National Provider Identifier
1114690930
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
42103 Issued in CA
Practice address
1320 W Pearl St
Anaheim, CA 92801-5941
Phone
(714) 780-1174
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 42103 CA Primary

Addresses

Primary practice location

1320 W Pearl St
Anaheim, CA 92801-5941

Mailing address

1320 West Pearl St
Anaheim, CA 92801-2327
Phone (714) 780-1174

Other practice location 1

9101 Whittier Blvd
Pico Rivera, CA 90660-2405
Phone (562) 801-4626

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

State licenses

LicenseStateTypeSpecialty
42103CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1114690930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WEST PEARL ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012327",
            "telephone_number": "714-780-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W PEARL ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015941",
            "telephone_number": "714-780-1174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9101 Whittier Blvd",
            "address_purpose": "LOCATION",
            "city": "Pico Rivera",
            "state": "CA",
            "postal_code": "906602405",
            "country_code": "US",
            "telephone_number": "562-801-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "CRYSTAL",
        "middle_name": "ADILENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "42103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.