Provider Demographics
NPI:1609949866
Name:CHALMERS, CRYSTAL LYNN (MS)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:CHALMERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 JAN CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4418
Mailing Address - Country:US
Mailing Address - Phone:530-899-3277
Mailing Address - Fax:530-895-0811
Practice Address - Street 1:15 JAN CT
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4418
Practice Address - Country:US
Practice Address - Phone:530-899-3277
Practice Address - Fax:530-895-0811
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU776231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP68261OtherFNRC
CAAU0007760Medicaid
CA0045173OtherSSI
CAS01282Medicare UPIN
CAAU0007760Medicaid