Provider Demographics
NPI:1225346273
Name:BROWN, CRYSTAL MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 W AVENUE J12 APT 107
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4656
Mailing Address - Country:US
Mailing Address - Phone:706-631-1445
Mailing Address - Fax:
Practice Address - Street 1:43845 10TH ST W STE 2B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4800
Practice Address - Country:US
Practice Address - Phone:661-940-9094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator