Crystal Amanda Wade

Primary specialty

HomemakerTaxonomy code 376J00000X

Practice address

12023 3Rd St
Yucaipa, CA 92399-2743

Phone

(626) 633-7854

NPI assigned

Apr 12, 2023

Last updated

Apr 12, 2023By the provider in NPPES

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1235825308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 DODGE WAY",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603885",
            "telephone_number": "626-633-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12023 3RD ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992743",
            "telephone_number": "626-633-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CRYSTAL",
        "middle_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Homemaker in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Homemaker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.