Provider Demographics
NPI:1407242704
Name:ANDERSEN, CRYSSA BYERS (LMFT)
Entity Type:Individual
Prefix:
First Name:CRYSSA
Middle Name:BYERS
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 21ST ST
Mailing Address - Street 2:APT E
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2183
Mailing Address - Country:US
Mailing Address - Phone:949-433-9742
Mailing Address - Fax:
Practice Address - Street 1:3714 S PARTON ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-4831
Practice Address - Country:US
Practice Address - Phone:714-824-9896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist