Liset Cristino Crespin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW67583 Issued in CA

Practice address

800 S Santa Anita Ave
Arcadia, CA 91006-3536

Phone

(626) 254-5000

Fax

(626) 577-4988

NPI assigned

Aug 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Portals House Inc

  • Exclusive Provider Organization
  • Los Angeles, CA
  • NPI 1134389893
  NPD (past)

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1659564532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WILSHIRE BLVD STE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574310",
            "telephone_number": "323-290-4345",
            "fax_number": "213-388-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S SANTA ANITA AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063536",
            "telephone_number": "626-254-5000",
            "fax_number": "626-577-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPIN",
        "first_name": "LISET",
        "middle_name": "CRISTINO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW67583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suzanne Reese Coulter, DDS
• Taylor Louise Cox
• James McDermott Crabtree, DDS
• Jazlyn Hailey Crawford
• Creative Licensed Marriage and Family Therapist, Inc.
• Jennifer Melissa Crespo, M.A.
• Marita G Cristobal
• Cross Pacific Technology Inc
• Ann Marie Crowder, PTA
• Anali Cruz

• Clinical Social Worker in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.