Individual provider Active NPI

Crystal Lestari, PHARMD

  • Pharmacist
  • Bermuda Dunes, CA
National Provider Identifier
1144733296
Registry record updated Nov 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77062 Issued in CA
Practice address
42010 Washington St
Bermuda Dunes, CA 92203-9610
Phone
(760) 772-9122
NPI assigned
Nov 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77062 CA Primary

Addresses

Primary practice location

42010 Washington St
Bermuda Dunes, CA 92203-9610

Mailing address

42010 Washington St
Bermuda Dunes, CA 92203-9610
Phone (760) 772-9122

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

LicenseStateTypeSpecialty
77062CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510444800000",
    "number": "1144733296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42010 WASHINGTON ST",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039610",
            "telephone_number": "760-772-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42010 WASHINGTON ST",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039610",
            "telephone_number": "760-772-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTARI",
        "first_name": "CRYSTAL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-12",
        "last_updated": "2017-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bermuda Dunes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2017; 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.