CRYSTAL MARIE DICKERSON NPI 1871917468

NPI Information

NPI: 1871917468
Provider Name: CRYSTAL MARIE DICKERSON
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
121 DOWNEY AVE
MODESTO, CA
ZIP 95354
Phone: (209) 341-1824
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Crystal Marie Dickerson is a professional counselor in Modesto, CA. Crystal Marie Dickerson NPI is 1871917468. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

121 DOWNEY AVE
MODESTO, CA
ZIP 95354-208
Phone: (209) 341-1824

The enumeration date for this NPI number is 2/18/2014 and was last updated on 12/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	101YP2500X	Counselor	Professional	132613		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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