Individual provider Active NPI

Cristal Cunningham, MA, LMFT

  • Marriage & Family Therapist
  • Encino, CA
National Provider Identifier
1700479847
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120101 Issued in CA
Practice address
16530 Ventura Blvd Ste 400
Encino, CA 91436-4551
Phone
(323) 207-5404
NPI assigned
Feb 19, 2021
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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 120101 CA Primary

Addresses

Primary practice location

16530 Ventura Blvd Ste 400
Encino, CA 91436-4551

Mailing address

PO Box 1490
Studio City, CA 91614-0490

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10209 Lurline Ave
Unit C
Chatsworth, CA 91311-3271

10209 Lurline Ave Unit C
Chatsworth, CA 91311-7730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
120101CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Dawn Family Therapy, Prof. Corp. Marriage & Family Therapist Current Accepting new patients

Locations

16530 Ventura Blvd
Ste 400
Encino, CA 91436
Phone (213) 855-2185

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1700479847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1490",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916140490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16530 VENTURA BLVD STE 400",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364551",
            "telephone_number": "323-207-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "CRISTAL",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.