Provider Demographics
NPI:1265811509
Name:PEREIRA, CRYSTAL ANNETTE (LMFT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANNETTE
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ANNETTE
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 42171
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93384-2171
Mailing Address - Country:US
Mailing Address - Phone:661-319-1832
Mailing Address - Fax:
Practice Address - Street 1:1430 TRUXTUN AVE
Practice Address - Street 2:FLOOR 5
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5246
Practice Address - Country:US
Practice Address - Phone:661-665-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF85762106H00000X
CALMFT119392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist