Individual provider Active NPI

Crystal Lauren Min

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1356121677
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95026278 Issued in CA
Practice address
3030 W Olympic Blvd Ste 217
Los Angeles, CA 90006-6507
Phone
(213) 550-2159
NPI assigned
Oct 3, 2023
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95026278 CA Primary

Addresses

Primary practice location

3030 W Olympic Blvd Ste 217
Los Angeles, CA 90006-6507

Mailing address

3030 W Olympic Blvd Ste 217
Los Angeles, CA 90006-6507
Phone (562) 805-6869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240106000870 CA Practitioner - Nurse Practitioner 4789035478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Together Mental Health a Nursing CorpGroup PAC ID 2264767672, 3 clinicians

Practice addresses (Care Compare)

1500 E Chevy Chase Dr
Suite 201
Glendale, CA 91206-4199
Phone (818) 863-4099

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

3030 W Olympic Blvd
Suite 217
Los Angeles, CA 90006-6507
Phone (213) 550-2159

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95026278CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Adventist Medical Center CurrentSince Nov 1, 2025 Accepting new patients
Glendale Adventist Medical Center CurrentSince Nov 1, 2025 Accepting new patients

Locations

1500 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 863-4099

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1356121677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 217",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066507",
            "telephone_number": "562-805-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 217",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066507",
            "telephone_number": "213-550-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "CRYSTAL",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.