Active NPI
Crystal Clark
- Occupational Therapist
- Rosamond, CA
National Provider Identifier
1154861292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR3025
- Practice address
- 2601 W Rosamond Blvd
Rosamond, CA 93560-6434 - Phone
- (661) 256-5000
- NPI assigned
- Mar 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR3025 | AR | Primary |
Addresses
Primary practice location
2601 W Rosamond Blvd
Rosamond, CA 93560-6434
Mailing address
3145 Summer Breeze Ave
Rosamond, CA 93560-7820
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTR3025 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1154861292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3145 SUMMER BREEZE AVE",
"city": "ROSAMOND",
"state": "CA",
"postal_code": "935607820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 W ROSAMOND BLVD",
"city": "ROSAMOND",
"state": "CA",
"postal_code": "935606434",
"telephone_number": "661-256-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-07",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR3025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosamond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.