CRYSTAL THAO (NPI# 1609183748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609183748 |
| Entity Type | Individual |
| Full Name | CRYSTAL THAO |
| Credential | LCSW |
| Practice Address |
1031 Waterloo Rd Stockton CA 95205-4256 |
| Mailing Address |
10048 Tivoli Dr Stockton CA 95212-3115 |
| Practice Telephone | 2099405639 |
| Mailing Telephone | 5302829969 |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2019-08-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
88349 | CA | Behavioral Health & Social Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831605088 | Crystal Thao | Behavior Technician | 5801 Ne Cornelius Pass Rd, Hillsboro, OR 97124-9370 | 2017-12-26 |
| Street Address |
1031 WATERLOO RD |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629609284 | La Roy'a Rochell Peace | Social Worker | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2020-01-31 |
| 1184192411 | Adriana Vanessa Nunez Lopez | Nurse Practitioner | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2018-11-05 |
| 1285059923 | Community Medical Centers, Inc | Clinic/Center | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2014-03-04 |
| 1245672716 | Hailu Solomon Mehanzel | Dentist | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2013-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1518464692 | Szarisse Fernandez | Pharmacist | 2040 E. Mariposa Rd., Stockton, CA 95205 | 2018-04-06 |
| 1467820019 | San Joaquin County Bhs | Non-emergency Medical Transport (VAN) | 1149 N. El Dorado St., Stockton, CA 95205 | 2015-09-11 |
| 1346617651 | Kevin G.y. Tom | Pharmacist | 1528 Fremont St, Stockton, CA 95205 | 2015-08-24 |
| 1578749149 | Peebles Family Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 404 North Broadway Ave, Stockton, CA 95205 | 2008-01-14 |
| 1780874149 | Mv Transportation | Non-emergency Medical Transport (VAN) | 1250 South Wilson Way, Mv Transportation Ste #a1, Stockton, CA 95205 | 2007-07-31 |
| 1467513549 | Stockton Pharmacy | Pharmacy | 3330 E Main St, Stockton, CA 95205 | 2006-12-13 |
| 1174155170 | Phillip Brandon Long | Pharmacist | 2040 E Mariposa Rd, Stockton, CA 95205 | 2020-02-07 |
| 1558904136 | Angela Moss Burns | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2019-10-25 |
| Find all providers in zip 95205 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528696366 | Benica Jane Foster | Social Worker | 343 E Main St Ste 919, Stockton, CA 95202-2932 | 2020-03-28 |
| 1881226702 | Dawayla Sheree Williams | Social Worker | 4719 Quail Lakes Dr Ste G1046, Stockton, CA 95207-5267 | 2020-02-08 |
| 1407487200 | Lecia Harrison | Social Worker | 4216 Sturgeon Rd, Stockton, CA 95219-4937 | 2020-01-30 |
| 1821632670 | Sandra L Barrios | Social Worker | 2001 Tillie Lewis Dr, Stockton, CA 95206-4603 | 2019-11-05 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1982191649 | Diego Garcia | Social Worker | 10229 Crocker Rd, Stockton, CA 95206-9506 | 2018-04-18 |
| 1679082283 | Alexis Alexandria Pigorsch | Social Worker | 2431 W March Ln Ste 100, Stockton, CA 95207-8211 | 2017-09-26 |
| 1255780078 | Taneka Carnes-jackson | Social Worker | 3131 Arch Airport Rd, #31072, Stockton, CA 95213-3000 | 2016-06-13 |
| 1700281367 | Carol Robinson | Social Worker | 1149 El Dorado St., Stockton, CA 95202 | 2014-10-24 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.