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General NPI Number Information
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NPI Number | 1841986429
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Entity Type | Organization
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Legal Business Name | CRYSTAL A. WEST
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 212 GROVE ST
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City | BISHOP
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State | CA
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Zip | 93514-2620
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Country | US
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Telephone | 760-872-2418
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Fax |
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Provider Business Mailing Address
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Address Line | 212 GROVE ST
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City | BISHOP
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State | CA
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Zip | 93514-2620
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Country | US
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Telephone | 760-872-2418
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | CRYSTAL WEST
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Credential | MA, LMFT
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Telephone | 760-872-2418
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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 |
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License Number State |
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