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NPI Code Detail

MEDICARE: CRYSTAL LEA EASTBURN LCSW

MEDICARE: CRYSTAL LEA EASTBURN LCSW
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
11041C0700XClinical Social WorkerLCSW 65615CA

General Provider Information

NPI Number : 1164811634
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL LEA EASTBURN LCSW
Provider Business Mailing Address
First Line : 721 8TH ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304-2224
Country : US
Telephone Number : 661-326-9700
Fax Number :
Provider Business Practice Location Address
First Line : 721 8TH ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304-2224
Country : US
Telephone Number : 661-326-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2015
Last Update Date : 06/03/2025

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Directions to “ CRYSTAL LEA EASTBURN LCSW” Practice Location

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