Active NPI
Crystal Martin
- Counselor
- San Francisco, CA
National Provider Identifier
1154831444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2198 Cayuga Ave
San Francisco, CA 94112-4023 - Phone
- (650) 784-1567
- NPI assigned
- Oct 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2198 Cayuga Ave
San Francisco, CA 94112-4023
Mailing address
1216 73Rd Ave Apt a
Oakland, CA 94621-2920
Phone (650) 291-4765
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171M00000X | Medicaid | CA | |
| 101Y00000X | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1154831444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 73RD AVE APT A",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946212920",
"telephone_number": "650-291-4765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2198 CAYUGA AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941124023",
"telephone_number": "650-784-1567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CRYSTAL",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-02",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171M00000X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101Y00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.