Healthcare Provider Details

I. General information

NPI: 1487389185
Provider Name (Legal Business Name): CRYSTAL A DYRCZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GEER RD
TURLOCK CA
95380-3311
US

IV. Provider business mailing address

875 GEER RD
TURLOCK CA
95380-3311
US

V. Phone/Fax

Practice location:
  • Phone: 209-633-3057
  • Fax:
Mailing address:
  • Phone: 209-846-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: