Crystal Marie Dickerson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

155533 Issued in CA

Practice address

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Phone

(323) 205-7088

Fax

(833) 419-0181

NPI assigned

Feb 18, 2014

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

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

Specialty

Marriage and Family Therapist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764374400000",
    "number": "1871917468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MOSELLE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953585655",
            "telephone_number": "209-556-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 E Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911016143",
            "country_code": "US",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Lime St Ste 711",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925012978",
            "country_code": "US",
            "telephone_number": "909-470-1456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "155533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mehrshid Zandifar Dias, MA, CHT
• Carmelita Diaz
• Colleen Diaz, SLP
• Velicia Natalie Diaz, MSW
• Janice E Dibenedetto, P.T.
• Christina-Uyen Diep, PHARM.D.
• Cindy Diep, MSPT
• Vanessa Diep, PT, DPT
• Mary Julie Digeronimo, OTR
• Ildiko Judith Dihen, PA-C

• Marriage & Family Therapist in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.