Jarrett Andrew Winslow Minor Crockwell

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

8142 Sunland Blvd
Sun Valley, CA 91352

Phone

(818) 582-8832

Fax

(818) 582-8836

NPI assigned

Jun 29, 2021

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

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.

• The Teen Project, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Sun Valley, CA
  • NPI 1457908618
  NPD
• The Teen Project, Inc.

  • Substance Abuse Rehabilitation Facility
  • Sun Valley, CA
  • NPI 1194677880
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1285204644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2768 BULA CT",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910014634",
            "telephone_number": "404-482-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8142 SUNLAND BLVD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "91352",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKWELL",
        "first_name": "JARRETT",
        "middle_name": "ANDREW WINSLOW MINOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comfort Keepers Hospice Inc
• Concierge Medline
• Shannon Copsin
• Counseling4Kids, Inc.
• Cranbelve Medical Group
• Gerardo Cruz Cruz
• D Phan Medical Corp
• D Sangho Park DDS Inc
• Raffi Hriyr Dadaian, DMD
• Penah Dadayan, PHARM.D

• Behavior Technician in Sun Valley, CA
• Providers in Sun Valley, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.