Crystal Veronica Burns

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

76578 Issued in CA

Practice address

155 W Hospitality LN Ste 245
San Bernardino, CA 92408-3318

Phone

(909) 939-5007

NPI assigned

Oct 26, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

• Theraville Counseling Services, a LCSW Corporation

  • Clinical Social Worker
  • San Bernardino, CA
  • NPI 1366084360

  Clinical

  NPD Authorized official
• Theraville PLLC

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1326973983

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1962788620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 559",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922230559",
            "telephone_number": "951-386-9709",
            "fax_number": "951-602-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W HOSPITALITY LN STE 245",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083318",
            "telephone_number": "909-939-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6090 W Ramsey St",
            "address_purpose": "LOCATION",
            "city": "Banning",
            "state": "CA",
            "postal_code": "922203052",
            "country_code": "US",
            "telephone_number": "951-330-8241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 N California Ave",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922232113",
            "country_code": "US",
            "telephone_number": "951-386-9709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 E Cooley Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "92324",
            "country_code": "US",
            "telephone_number": "951-386-9709",
            "fax_number": "951-602-6508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 E Cooley Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923243966",
            "country_code": "US",
            "telephone_number": "951-386-9709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "CRYSTAL",
        "middle_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Burdick Navarro
• Jennifer D Burgoz
• Catherine Lee Burkdoll, RN
• Kimberly Desiree Burkholder Sostre
• Vani Burnette, LMFT
• John Robert Burns, MBA, CSAC
• Kayla Burse
• Regina Burse
• Angelica Lynne Rachel Marie Bursey
• Ananda Burson

• All providers in San Bernardino, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.