MRS. KRYSTAL MATSUE LONG (NPI# 1083780290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083780290 |
| Entity Type | Individual |
| Full Name | MRS. KRYSTAL MATSUE LONG |
| Credential | B.A., LC |
| Practice Address |
2034 Lake Tahoe Blvd South Lake Tahoe CA 96150-6499 |
| Mailing Address |
1196 Gold Dust Trl South Lake Tahoe CA 96150-4520 |
| Practice Telephone | 5305419355 |
| Mailing Telephone | 5304141348 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-12-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174N00000X | Lactation Consultant, Non-RN | Other Service Providers | ||
| N | 374J00000X | Doula | Nursing Service Related Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1195 Gold Dust Trail, South, CA 961509615 | 4152657121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942555974 | Krystal L. Long | Optometrist | 900 Nicollet Mall, Minneapolis, MN 55403-2530 | 2012-07-16 |
| Street Address |
2034 LAKE TAHOE BLVD |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-6499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063724508 | Ha Dang | Acupuncturist | 2034 Lake Tahoe Blvd, South Lake Tahoe, CA 96150 | 2010-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 174N00000X |
| Grouping | Other Service Providers |
| Classification | Lactation Consultant, Non-RN |
| An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization. |
| Notes: Source: National Uniform Claim Committee [1/1/2011: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922722 | Ashley Elizabeth Tehrani | Lactation Consultant, Non-RN | 3722 Arnold Ave Apt 5, San Diego, CA 92104-3481 | 2020-11-02 |
| 1760083216 | Teresa Marie Peters | Lactation Consultant, Non-RN | 1120 S Santa Anita Ave Apt A, Arcadia, CA 91006-4029 | 2020-11-02 |
| 1982203667 | Paula Conriquez | Lactation Consultant, Non-RN | 6230 Drop Off Rd, Pollock Pines, CA 95726-9633 | 2020-10-22 |
| 1265031397 | Arabella Hancock | Lactation Consultant, Non-RN | 1038 Rose Ave, Pasadena, CA 91107-1867 | 2020-10-20 |
| 1194331314 | Madison Benstead | Lactation Consultant, Non-RN | 26672 Fino Ct, Redlands, CA 92373-4318 | 2020-09-22 |
| 1952917189 | Kayla Benado | Lactation Consultant, Non-RN | 4653 California Blvd, Santa Maria, CA 93455-4158 | 2020-09-22 |
| 1376152835 | Rebecca Howell | Lactation Consultant, Non-RN | 4811 N Bellflower Blvd, Long Beach, CA 90808-1121 | 2020-07-30 |
| 1740898659 | Heidi Burke-pevney | Lactation Consultant, Non-RN | 1808 Sheridan Way, San Marcos, CA 92078-0929 | 2020-07-16 |
| 1942828140 | Megan Zoe Barrett | Lactation Consultant, Non-RN | 49 Bonita Ave, Piedmont, CA 94611-3947 | 2020-07-14 |
| 1225659840 | Antonina Proshak | Lactation Consultant, Non-RN | 811 Grand Ave Ste A1, Sacramento, CA 95838-3466 | 2020-05-05 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
Please comment or provide details below to improve the information on MRS. KRYSTAL MATSUE LONG.
| 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.