Individual provider Active NPI

Crystal Valencia

  • Marriage & Family Therapist
  • Northridge, CA
National Provider Identifier
1124583836
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143795 Issued in CA
Practice address
9650 Zelzah Ave
Northridge, CA 91325-2003
Phone
(818) 993-9311
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Rehabilitation Practitioner 225400000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 143795 CA Primary

Addresses

Primary practice location

9650 Zelzah Ave
Northridge, CA 91325-2003

Mailing address

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone (818) 686-3000

Other practice location 1

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone (818) 686-3000

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
143795CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Guidance Center Marriage & Family Therapist 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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1124583836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252003",
            "telephone_number": "818-993-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 Eldridge Ave",
            "address_purpose": "LOCATION",
            "city": "Lake View Terrace",
            "state": "CA",
            "postal_code": "913426506",
            "country_code": "US",
            "telephone_number": "818-686-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.