CRYSTAL WAGNER (NPI# 1740812338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740812338 |
| Entity Type | Individual |
| Full Name | CRYSTAL WAGNER |
| Practice Address |
1343 N Grand Ave Ste 200 Covina CA 91724-4043 |
| Mailing Address |
471 E Rio Grande St Pasadena CA 91104-2253 |
| Practice Telephone | 6263899747 |
| Mailing Telephone | 6266165137 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154842722 | Crystal Wagner | Counselor | 6013 S Redwood Rd, Taylorsville, UT 84123-5220 | 2017-07-04 |
| 1215393319 | Crystal Wagner | Physician Assistant | 18200 Katy Fwy, Houston, TX 77094-1285 | 2016-01-06 |
| 1689049033 | Crystal Wagner | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2015-12-10 |
| Street Address |
1343 N GRAND AVE STE 200 |
| City | COVINA |
| State | CA |
| Zip Code | 91724-4043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172175 | Stephanie Marie Chavez | Behavior Technician | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-11 |
| 1043861370 | Wei-hsuan Yi | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-27 |
| 1902457476 | Iris Oi Yi Liu | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-25 |
| 1629629290 | Hector Estrada | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-25 |
| 1255982773 | Nishma Chel | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-25 |
| 1558912329 | Trami Thi Do | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-24 |
| 1568013290 | Luse Say Lieu | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-24 |
| 1669021655 | Breanna Figueroa | Assistant Behavior Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2019-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902320922 | Kimberly Suzanne Manzanares-mora | Rehabilitation Practitioner | 1359 North Grand Avenue, Covina, CA 91724 | 2017-08-01 |
| 1689194680 | Cynthia Garcia | Counselor | 1359 N. Grand Ave., Covina, CA 91724 | 2017-06-21 |
| 1386191963 | West Covina Group Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1274 Center Court Dr, #208, Covina, CA 91724 | 2016-09-01 |
| 1184094781 | Veronica May Roberts | Licensed Vocational Nurse | 222 S. Wilson Ave, Covina, CA 91724 | 2015-09-25 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1548583602 | Lille-anne Nzeribe | Rehabilitation Practitioner | 1126 N. Grand Ave. Suite D, Covina, CA 91724 | 2010-03-03 |
| 1154534212 | Verna L Lewis | Marriage & Family Therapist | 420 South Grand Ave., Covina, CA 91724 | 2007-05-07 |
| 1093937310 | Heather Annn Pedevillano | Specialist/Technologist | 1805 E. Lomira Dr, Covina, CA 91724 | 2007-05-03 |
| 1669503579 | Maritza Mercedes Reyes | Rehabilitation Practitioner | 1411 N. Grand Ave., Covina, CA 91724 | 2007-03-09 |
| 1417014085 | Bernadette Luyun Guaring Bagay | Dentist | 984 E Badillo St, Suite E, Covina, CA 91724 | 2007-01-03 |
| Find all providers in zip 91724 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578104790 | Alda Shin Shin | Behavioral Analyst | 1343 S. Grand Avenue, Suite 200, Covina, CA 91723 | 2019-09-30 |
| 1093365397 | Hector Palomino Jr. | Behavioral Analyst | 1343 N Grand Ave Ste 201, Covina, CA 91724-4020 | 2019-09-18 |
| 1508363813 | Julissa Vanessa Mejia-sorto | Behavioral Analyst | 235 E Badillo St, Covina, CA 91723-2116 | 2018-04-12 |
| 1871956128 | Vanessa Munoz | Behavioral Analyst | 170 E Puente St, Covina, CA 91723-3001 | 2016-04-04 |
| 1922344720 | Maryam Vosogh | Behavioral Analyst | 210 N Citrus Ave, Covina, CA 91723-2060 | 2012-12-25 |
| 1427657071 | Sara Spurrier | Behavioral Analyst | 210 N Citrus Ave # A1, Covina, CA 91723-2060 | 2020-10-23 |
| 1023643210 | Deepti Vyas | Behavioral Analyst | 1274 Center Court Dr Ste 211, Covina, CA 91724-3668 | 2020-03-08 |
| 1346874468 | Sophie Ederaine | Behavioral Analyst | 1274 Center Court Dr Ste 211, Covina, CA 91724-3668 | 2020-02-27 |
| 1922647882 | Zinnia Ynez Tilden | Behavioral Analyst | 1274 Center Court Dr Ste 211, Covina, CA 91724-3668 | 2019-12-24 |
| 1043859986 | Jasemine Monet Lakey | Behavioral Analyst | 1274 Center Court Dr Ste 211, Covina, CA 91724-3668 | 2019-12-23 |
| Find all providers in COVINA | ||||
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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.