Crystal Shauna Roncancio

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

900 5TH Ave Ste 150
San Rafael, CA 94901-2928

Phone

(415) 457-6964

NPI assigned

Sep 20, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1225311863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 CANAL ST APT 9",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014365",
            "telephone_number": "415-259-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 5TH AVE STE 150",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012928",
            "telephone_number": "415-457-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONCANCIO",
        "first_name": "CRYSTAL",
        "middle_name": "SHAUNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Roman
• Alexandrea Denise Romano, PHARM.D., RPH
• Irene P Romano, PHARMD
• Mikelle Monique Romo, OTR/L
• Ron Andrews Medical Co
• Rama Ronen, PH.D
• Mia Elana Roodhuyzen
• Susan Patricia Rook-Thomas, LMFT
• Penny S Roper
• Angelica Roque

• Mental Health Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.