Individual provider Active NPI

Crystal Cadena

  • Marriage & Family Therapist
  • Manteca, CA
National Provider Identifier
1497016745
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF 69321 Issued in CA
Practice address
129 E Center St Ste 3
Manteca, CA 95336-4648
Phone
(209) 239-5553
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF 69321 CA Primary

Addresses

Primary practice location

129 E Center St Ste 3
Manteca, CA 95336-4648

Mailing address

129 E Center St Ste 3
Manteca, CA 95336-4648
Phone (209) 239-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20250530002388 CA Practitioner - Marriage and Family Therapist 8628587888 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
97230CAMDClinical Social Worker
IMF 69321CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin County Behavioral Health Services CurrentSince Mar 21, 2025 Accepting new patients
San Joaquin Behavioral Health Services Marriage & Family Therapist Current Accepting new patients
County of San Joaquin CurrentSince Mar 21, 2025 Accepting new patients
Valley Community Counseling Services, Inc Past Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1497016745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 E CENTER ST STE 3",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364648",
            "telephone_number": "209-239-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E CENTER ST STE 3",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364648",
            "telephone_number": "209-239-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADENA",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 69321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.