Provider Demographics
NPI:1124543186
Name:WEST, CRYSTAL (LMFT)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2620
Mailing Address - Country:US
Mailing Address - Phone:760-872-2418
Mailing Address - Fax:
Practice Address - Street 1:212 GROVE ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2620
Practice Address - Country:US
Practice Address - Phone:760-872-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT125040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist