1164917068 NPI number — MS. KRYSTAL VIVIENNE PATRICIA HASSAN FSD, CBC, CPPS,

Table of content: MS. KRYSTAL VIVIENNE PATRICIA HASSAN FSD, CBC, CPPS, (NPI 1164917068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164917068 NPI number — MS. KRYSTAL VIVIENNE PATRICIA HASSAN FSD, CBC, CPPS,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASSAN
Provider First Name:
KRYSTAL
Provider Middle Name:
VIVIENNE PATRICIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FSD, CBC, CPPS,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164917068
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
C/O COEXIST FAMILY CONSULTING & SERVICES, LLC
Provider Second Line Business Mailing Address:
7901 4TH ST N # 34423
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-897-8866
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7901 4TH ST N # 34423
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33702-4305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-897-8866
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 172V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133NN1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 127098500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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