Individual provider Active NPI

Cristal Guerrero

  • Marriage & Family Therapist
  • San Dimas, CA
National Provider Identifier
1164915070
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT154421 Issued in CA
Practice address
180 Via Verde Ste 200
San Dimas, CA 91773-3993
Phone
(909) 599-1227
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X LMFT154421 CA Primary

Addresses

Primary practice location

180 Via Verde Ste 200
San Dimas, CA 91773-3993

Mailing address

180 Via Verde Ste 200
San Dimas, CA 91773-3993
Phone (909) 599-1227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609002339 CA Practitioner - Marriage and Family Therapist 7719497775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT154421CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Apr 30, 2025 Accepting new patients
Eggleston Youth Centers, Inc. PastSince Nov 1, 2020 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1164915070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 VIA VERDE STE 200",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733993",
            "telephone_number": "909-599-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 VIA VERDE STE 200",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733993",
            "telephone_number": "909-599-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "CRISTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT154421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.