MEDICARE: MS. HALLEY IRENE CRUMB ADULT RESIDENTIAL

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
1	3747A0650X	Attendant Care Provider	6031500735	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6031500735	OTHER	CA	COMMUNITY CARE LICENSE DIVISION

General Provider Information

NPI Number	:	1164041687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HALLEY IRENE CRUMB ADULT RESIDENTIAL

Provider Business Mailing Address
First Line	:	2785 JOSEPH AVE APT 4
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-6259
Country	:	US
Telephone Number	:	650-461-0433
Fax Number	:

Provider Business Practice Location Address
First Line	:	16236 N LAKE ST
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93638-1615
Country	:	US
Telephone Number	:	650-461-0433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	06/16/2021

Similar Medicare Providers

1649861311 — GRISELDA DIAZ -LOPEZ
Practice Location Address:

16276 N LAKE ST
MADERA, CA
93638-1615

Practice Phone: 559-598-6933
Practice Fax: --

1699410738 — CONSTANCE S SPRATT LVN
Practice Location Address:

16236 N LAKE ST
MADERA, CA
93638-1615

Practice Phone: 559-691-4488
Practice Fax:

1700982931 — DR. GEORGYN JUDITH HITTELMAN M.F.T., PH.D.
Practice Location Address:

4 PLEASANT AVE
CORTE MADERA, CA
94925-1615

Practice Phone: 415-924-8606
Practice Fax: 415-924-4812

1629959986 — JESSICA SANCHEZ
Practice Location Address:

209 E 7TH ST
MADERA, CA
93638-3780

Practice Phone: 559-395-0451
Practice Fax:

1598351579 — ARACELI OLIVARES VILLA
Practice Location Address:

209 E 7TH ST
MADERA, CA
93638-3780

Practice Phone: 559-395-0451
Practice Fax:

1417594029 — DAWN THOMAS
Practice Location Address:

209 E 7TH ST
MADERA, CA
93638-3780

Practice Phone: 559-395-0451
Practice Fax:

Directions to “ MS. HALLEY IRENE CRUMB ADULT RESIDENTIAL” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.