CRYSTALIN RENNEE MENDOZA (NPI# 1942785407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942785407 |
| Entity Type | Individual |
| Full Name | CRYSTALIN RENNEE MENDOZA |
| Credential | CDPT |
| Practice Address |
510 Tacoma Ave S Tacoma WA 98402-5416 |
| Practice Telephone | 2535724750 |
| Practice Fax Number | 2532726666 |
| Mailing Telephone | 2535724750 |
| Mailing Fax Number | 2532726666 |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CHEMICAL DEPENDENCY COUNSELOR INTERN | CO60776673 | 01 |
| Street Address |
510 TACOMA AVE S |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-5416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619026721 | Natasha Christine Harris | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2007-01-09 |
| 1861039794 | Jacob Preston | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-12-10 |
| 1275178766 | Bruce Abelson | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-11-08 |
| 1366087934 | Zachary Mezel | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-11-07 |
| 1639634363 | Tami Tegge | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-02-06 |
| 1881159762 | Laura Lynn Vanhorn | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-02-05 |
| 1629542733 | Michelle Ward-hughes | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-01-11 |
| 1487127429 | Tyler Reed Kirk | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2019-01-02 |
| 1861964454 | Heather Marline Morgan | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2018-12-20 |
| 1093280711 | Jeremy S Myers | Counselor | 510 Tacoma Ave S, Tacoma, WA 98402-5416 | 2018-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868276 | Mind Over Matters, Pllc | Counselor | 2525 55th Ave Ne, Tacoma, WA 98422-3404 | 2020-10-14 |
| 1376140541 | Debra Tone | Counselor | 1219 Earnest Brazill St, Tacoma, WA 98405-4025 | 2020-10-01 |
| 1881201028 | Dallas Renae Neighbors | Counselor | 711 S 25th St Ste B, Tacoma, WA 98405-4306 | 2020-09-30 |
| 1306310925 | Nancy Rubi Rosas Rodriguez | Counselor | 5915 Orchard St W., Tacoma, WA 98467 | 2019-01-16 |
| 1740751668 | Jay Yourglich | Counselor | 3315 S 23rd St Ste 102, Tacoma, WA 98405-1615 | 2018-12-17 |
| 1407327927 | Lewis A Wilson | Counselor | 721 Fawcett Ave Ste 201, Tacoma, WA 98402-5502 | 2018-12-10 |
| 1386113207 | Patricia A Neagle | Counselor | 2316 S State St Ste B, Tacoma, WA 98405-2813 | 2018-11-20 |
| 1457829343 | Ron Rn Wilkins | Counselor | 721 Fawcett Ave Ste 102, Tacoma, WA 98402-5502 | 2018-11-08 |
| 1275001620 | Matthew Mixon | Counselor | 15318 14th Avenue Ct E, Tacoma, WA 98445-2496 | 2018-11-04 |
| 1124593017 | Elisa Marie Matthews | Counselor | 5315 S Orchard St, Tacoma, WA 98467-3686 | 2018-10-08 |
| Find all providers in TACOMA | ||||
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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.