Provider Demographics
NPI:1366007239
Name:NOYES, CRYSTAL
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:
Last Name:NOYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14312 GRAY FOX LN
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7472
Mailing Address - Country:US
Mailing Address - Phone:562-396-8497
Mailing Address - Fax:
Practice Address - Street 1:18818 OUTER HWY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2323
Practice Address - Country:US
Practice Address - Phone:760-995-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator