Crystal Rowan-Claire Udehn, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

13478 Issued in CA

Practice address

28780 Single Oak Dr
Ste. 290
Temecula, CA 92590-3625

Phone

(951) 693-5871

Fax

(951) 693-5872

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Crystal M. Udehn Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Rancho Physical Therapy, Inc.

  • Physical Therapist
  • Temecula, CA
  • NPI 1679541320
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1124281142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "STE. 290",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903625",
            "telephone_number": "951-693-5871",
            "fax_number": "951-693-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDEHN",
        "first_name": "CRYSTAL",
        "middle_name": "ROWAN-CLAIRE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASHINGTON DEPT. OF LABOR AND INDUSTRIES",
            "identifier": "0237659",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "SP0134780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "UDEHN",
            "middle_name": "M.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Linda Udoffia
• Richard Elliott Uhler, D.O.
• Jenna Uhrik, MS
• Michelle Janett Ulloa
• Ultimate Anesthesia Advanced Practice Nursing Corp

• Speech-Language Pathologist in Temecula, CA
• Providers in Temecula, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.