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General NPI Number Information
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NPI Number | 1740847979
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Entity Type | Individual
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Provider Name | CRYSTAL DEANNA OSBORN LMFT, CSCT, CST
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Gender | Female
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 6371 HAVEN AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91737-6943
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Country | US
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Telephone | 909-303-0969
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Fax | 909-481-5753
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | EHRENBERG
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State | AZ
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Zip | 85334-0715
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Country | US
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Telephone | 909-303-0969
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Fax | 909-481-5753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 113418
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 113418
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License Number State | CA
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