Provider Demographics
NPI:1518785609
Name:ZAMUDIO, CRYSTAL NICOLE (LMFT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:NICOLE
Last Name:ZAMUDIO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-0523
Mailing Address - Country:US
Mailing Address - Phone:559-736-1574
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 523
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93279-0523
Practice Address - Country:US
Practice Address - Phone:559-736-1574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist