Crystal Nicole Purdue

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

74066 Issued in CA

Practice address

200 E Katella Ave
Orange, CA 92867-4804

Phone

(714) 547-6494

NPI assigned

Jan 14, 2016

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Crystal Nicole Joosten Former name

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mindful Health Solutions a Professional Medical Corporation

  dba TMS Health Solutions

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1881894483
  Medicare reassignment NPD
• Mariposa Women and Family Center

  dba ADAS Mariposa Women's Center CalWORKs Orange

  • Case Management Agency
  • Orange, CA
  • NPI 1245535293
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1801252226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 W ORANGEWOOD AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682053",
            "telephone_number": "714-547-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E KATELLA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674804",
            "telephone_number": "714-547-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDUE",
        "first_name": "CRYSTAL",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "74066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "JOOSTEN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pulmonary Consultants & Primary Care Physicians Medical Group, Inc.
• Pulmonary Consultants and Primary Care Physicians Medical Group Inc
• Pulmonary Consultants and Primary Care Physicians Medical Group Inc
• Ernest Pun
• Hannah Marie Purcell
• Sonia Puri
• Sunita Puri, M.D.
• Susan Purrington, PSYD
• Lucas Akihiko Puttock, DO
• Taras Pylypiv, PA-C

• Clinical Social Worker in Orange, CA
• Providers in Orange, 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 Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.