Active NPI
Crystal Anne King, LMSW
- Social Worker
- Fairfield, CA
National Provider Identifier
1720758626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-18793
- Practice address
- 103 Bodin Circle
Travis AFB
Fairfield, CA 94535 - Phone
- (707) 423-3000
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-18793 | AZ | Primary |
Addresses
Primary practice location
103 Bodin Circle
Travis AFB
Fairfield, CA 94535
Mailing address
95-014 Waihonu St Apt E304
Mililani, HI 96789-3302
Phone (509) 637-3960
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-18793 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1720758626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-014 WAIHONU ST APT E304",
"city": "MILILANI",
"state": "HI",
"postal_code": "967893302",
"telephone_number": "509-637-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 BODIN CIRCLE",
"address_2": "TRAVIS AFB",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94535",
"telephone_number": "707-423-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "CRYSTAL",
"middle_name": "ANNE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-18793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.