Halley Irene Crumb, ADULT RESIDENTIAL

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

License

6031500735 Issued in CA

Practice address

16236 N Lake St
Madera, CA 93638-1615

Phone

(650) 461-0433

NPI assigned

Apr 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Retraining the Village

  • Addiction (Substance Use Disorder) Counselor
  • East Palo Alto, CA
  • NPI 1699394072
  NPD Authorized official

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1164041687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 JOSEPH AVE APT 4",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086259",
            "telephone_number": "650-461-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16236 N LAKE ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936381615",
            "telephone_number": "650-461-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMB",
        "first_name": "HALLEY",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "ADULT RESIDENTIAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": "CA",
            "license": "6031500735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CARE LICENSE DIVISION",
            "identifier": "6031500735",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@retraininghevillage.org",
            "affiliation": "N",
            "endpointDescription": "info@retraininghevillage.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "retrainingthevillage.org",
            "address_1": "16236 N Lake St",
            "city": "Madera",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936381615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Nicole Creamer
• Tom A Cross, PHARM.D.
• Jacqueline Nicole Crouch, PHARM.D.
• Vonda L. Crouse, M.D.
• Adam James William Crowder
• Aaron Justiniani Cruz, COTA
• Alondra B Cruz
• Ana Rosa Cruz
• Jenifer Cruz
• Nancy Cruz

• Attendant Care Provider in Madera, CA
• Providers in Madera, CA by specialty
• Attendant Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.