Individual provider Active NPI

Crystal Ankele

  • Psychologist
  • Long Beach, CA
National Provider Identifier
1376951871
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY34850 Issued in CA
Practice address
6060 N Paramount Blvd
Long Beach, CA 90805
Phone
(562) 634-9534
NPI assigned
Jul 28, 2014
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY34850 CA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

6060 N Paramount Blvd
Long Beach, CA 90805

Mailing address

6060 N Paramount Blvd
Long Beach, CA 90805-3711
Phone (562) 634-9534

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910004047 CA Practitioner - Clinical Psychologist 8224578851 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY34850CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Jun 6, 2024 Accepting new patients
Cognitive Insight Inc Current Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
Mission City Community Network, Inc. CurrentSince Jun 6, 2024 Accepting new patients

Locations

8527 Sepulveda Blvd
North Hills, CA 91343
Phone (310) 926-4865

15206 Parthenia St
Sepulveda, CA 91343

15201 Eleventh St
Ste 300
Victorville, CA 92395
Phone (760) 245-1640

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1376951871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 N PARAMOUNT BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908053711",
            "telephone_number": "562-634-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N PARAMOUNT BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "562-634-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKELE",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY34850",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.