Provider Demographics
NPI:1700019106
Name:MAHER, CHRYSTAL CATHERINE (PSYD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:CHRYSTAL
Middle Name:CATHERINE
Last Name:MAHER
Suffix:
Gender:F
Credentials:PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N MADISON AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2050
Mailing Address - Country:US
Mailing Address - Phone:626-240-4854
Mailing Address - Fax:877-991-8485
Practice Address - Street 1:65 N MADISON AVE STE 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2050
Practice Address - Country:US
Practice Address - Phone:626-240-4854
Practice Address - Fax:877-991-8485
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-07-3240103K00000X
CA23065103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst