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General NPI Number Information
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NPI Number | 1649140484
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Entity Type | Organization
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Legal Business Name | CRYSSA ANDERSEN MARRIAGE AND FAMILY THERAPIST, INC.
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 2900 BRISTOL ST STE G201
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City | COSTA MESA
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State | CA
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Zip | 92626-7914
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Country | US
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Telephone | 949-514-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 160 E 21ST ST APT E
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City | COSTA MESA
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State | CA
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Zip | 92627-2188
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Country | US
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Telephone | 949-433-9742
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRYSSA ANDERSEN
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Credential | LMFT
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Telephone | 949-433-9742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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