Provider Demographics
NPI:1124450333
Name:CHAPARRO, CRYSTEL NAYELI
Entity type:Individual
Prefix:MRS
First Name:CRYSTEL
Middle Name:NAYELI
Last Name:CHAPARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CRYSTEL
Other - Middle Name:NAYELI
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1440 VILLA ST
Mailing Address - Street 2:APT. A
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-1378
Mailing Address - Country:US
Mailing Address - Phone:719-244-5649
Mailing Address - Fax:
Practice Address - Street 1:26001 REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7762
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:909-894-7975
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA806131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker