Krystal Smith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY34381 Issued in CA

Practice address

1818 S State College Blvd Unit 321
Anaheim, CA 92806-8913

Phone

(775) 298-1362

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Tobias Moeller-Bertram MD Corporation

  • Pain Medicine (Anesthesiology) Physician
  • Rancho Mirage, CA
  • NPI 1922440684
  Medicare reassignment NPD
• Tobias Moeller-Bertram MD Corporation

  • Durable Medical Equipment & Medical Supplies
  • Indio, CA
  • NPI 1861389199
  NPD
• Moeller-Bertram Medical Corporation

  • Pain Medicine Physician
  • Rancho Mirage, CA
  • NPI 1699586388
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1437689338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 STEAMBOAT PKWY UNIT 7105",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895216373",
            "telephone_number": "248-885-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 S STATE COLLEGE BLVD UNIT 321",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928068913",
            "telephone_number": "775-298-1362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Delucchi Ln Ste 225",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895026582",
            "country_code": "US",
            "telephone_number": "248-885-9027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRYSTAL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34381",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY1151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janesa Lanae Smith
• Jeanne H. Smith, MD
• Jessica Smith
• Karina M Smith, DPT, OCS
• Kelsey Smith
• Lauren Smith
• Lauren Smith
• Megan Smith, RDN
• Melissa Smith
• Mya Claire Smith

• Clinical Psychologist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.