NPIMap

Organization Active NPI

Crystal Dawn Family Therapy, Prof. Corp.

  • Marriage & Family Therapist
  • Encino, CA
National Provider Identifier
1346954104
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
CRYSTAL DAWN FAMILY THERAPY, PROF. CORP.
Practice address
16530 Ventura Blvd Ste 400
Encino, CA 91436-4551
Phone
(323) 207-5404
NPI assigned
Jan 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Cristal Cunningham, LMFTNPI 1700479847
Title
President/Ceo
Phone
(323) 207-5404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

16530 Ventura Blvd Ste 400
Encino, CA 91436-4551

Mailing address

10209 Lurline Ave Unit C
Chatsworth, CA 91311-7730
Phone (323) 207-5404

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1346954104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10209 LURLINE AVE UNIT C",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913117730",
            "telephone_number": "323-207-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16530 VENTURA BLVD STE 400",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364551",
            "telephone_number": "323-207-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL DAWN FAMILY THERAPY, PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "CRISTAL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-207-5404",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.