Individual provider Active NPI

Crystal Rose White

  • Peer Specialist
  • San Diego, CA
National Provider Identifier
1619890704
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-ICEZRX Issued in CA
Practice address
4620 Alvarado Canyon Rd Ste 14
San Diego, CA 92120-4306
Phone
(858) 318-5977
NPI assigned
Aug 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-ICEZRX CA Primary

Addresses

Primary practice location

4620 Alvarado Canyon Rd Ste 14
San Diego, CA 92120-4306

Mailing address

4620 Alvarado Canyon Rd Ste 14
San Diego, CA 92120-4306
Phone (858) 318-5977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1619890704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 ALVARADO CANYON RD STE 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204306",
            "telephone_number": "858-318-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 ALVARADO CANYON RD STE 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204306",
            "telephone_number": "858-318-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CRYSTAL",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-ICEZRX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.