Healthcare Provider Details

I. General information

NPI: 1003771486
Provider Name (Legal Business Name): CRYSTAL LE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

IV. Provider business mailing address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

V. Phone/Fax

Practice location:
  • Phone: 408-842-7138
  • Fax: 408-842-0383
Mailing address:
  • Phone: 408-842-7138
  • Fax: 408-842-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: