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NPI Code Detail

MEDICARE: CRYSTAL LILY VAZQUEZ

MEDICARE: CRYSTAL LILY VAZQUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1063346765
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL LILY VAZQUEZ
Provider Business Mailing Address
First Line : 766 PEGGY DR # 766
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-3230
Country : US
Telephone Number : 619-704-4152
Fax Number :
Provider Business Practice Location Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ CRYSTAL LILY VAZQUEZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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