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NPI Code Detail

MEDICARE: CRYSTAL ANN LAWSON LMFT

MEDICARE: CRYSTAL ANN LAWSON LMFT
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
1101YM0800XMental Health Counselor82628CA
2106H00000XMarriage & Family Therapist137188CA

General Provider Information

NPI Number : 1609427160
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ANN LAWSON LMFT
Provider Business Mailing Address
First Line : 1640 NEWPORT BLVD STE 110
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-7762
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1640 NEWPORT BLVD STE 110
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-7762
Country : US
Telephone Number : 925-282-1778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2019
Last Update Date : 08/29/2024

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Directions to “ CRYSTAL ANN LAWSON LMFT” Practice Location

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