Individual provider Active NPI

Desiree Elaine Crump

  • Rehabilitation Practitioner
  • Sacramento, CA
National Provider Identifier
1871162164
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
225400000X Issued in CA
Practice address
600 Bercut Dr
Sacramento, CA 95811-0131
Phone
(916) 440-1500
Fax
(916) 440-1514
NPI assigned
Jun 21, 2021
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 225400000X CA Primary
Community Health Worker 172V00000X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

600 Bercut Dr
Sacramento, CA 95811-0131

Mailing address

3780 Rosin CT Ste 110
Sacramento, CA 95834-1698
Phone (916) 441-0226

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

LicenseStateTypeSpecialty
225400000XCAMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1871162164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 ROSIN CT STE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341698",
            "telephone_number": "916-441-0226",
            "fax_number": "916-441-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BERCUT DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958110131",
            "telephone_number": "916-440-1500",
            "fax_number": "916-440-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "DESIREE",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "225400000X",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.