Active NPI
Juanchito Delval Crisostomo, M.D.
- Psychiatry Physician
- Daly City, CA
National Provider Identifier
1730254186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A041361
- Practice address
- 375 89TH St
Daly City, CA 94015-1802 - Phone
- (650) 301-8650
- Fax
- (650) 301-8639
- NPI assigned
- Nov 21, 2006
- Last updated
- Dec 13, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A041361 | CA | Primary |
Addresses
Primary practice location
375 89TH St
Daly City, CA 94015-1802
Mailing address
9175 Pinehurst Dr
Roseville, CA 95747-6329
Phone (415) 260-9322
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A041361 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1730254186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9175 PINEHURST DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957476329",
"telephone_number": "415-260-9322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 89TH ST",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940151802",
"telephone_number": "650-301-8650",
"fax_number": "650-301-8639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISOSTOMO",
"first_name": "JUANCHITO",
"middle_name": "DELVAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A041361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daly City, CA
- County of San Mateo (San Mateo Medical Center)
- County of San Mateo (North County Youth)
- Carol Crane, PTA
- Burke Crawford
- Julianne Crimm, RN
- George Adam Crits, M.D.
- Kelsey Crooks, DPT
- Christian Cosca Cruz, MD
- Diana A. Cruz, DMD
- Crystalline Counseling, a Marriage & Family Therapy Corporation (Crystalline Counseling)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.