Individual provider Active NPI

Crystal Guadalupe Rosales

  • Marriage & Family Therapist
  • Monrovia, CA
National Provider Identifier
1427700186
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT149140 Issued in CA
Practice address
902 S Myrtle Ave
Monrovia, CA 91016-3427
Phone
(626) 357-3258
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X LMFT149140 CA Primary
Mental Health Counselor 101YM0800X AMFT131494 CA

Addresses

Primary practice location

902 S Myrtle Ave
Monrovia, CA 91016-3427

Mailing address

902 S Myrtle Ave
Monrovia, CA 91016-3427
Phone (626) 701-0808

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
I20241104003936 CA Practitioner - Marriage and Family Therapist 7911430582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

902 S Myrtle Ave
Monrovia, CA 91016-3427
Phone (626) 441-4221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT131494CAMDMental Health Counselor
LMFT149140CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Aug 26, 2024 Accepting new patients
Pacific Clinics CurrentSince Aug 26, 2024 Accepting new patients
Pacific Clinics Current Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

902 S Myrtle Ave
Monrovia, CA 91016
Phone (626) 303-1541

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1427700186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-701-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-357-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "CRYSTAL",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT149140",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT131494",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

Verify at the official NPI Registry.