1538049523 NPI number — CRYSTAL HELEN ORELLANA SCHOOL PSYCH, BCBA

Table of content: CRYSTAL HELEN ORELLANA SCHOOL PSYCH, BCBA (NPI 1538049523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538049523 NPI number — CRYSTAL HELEN ORELLANA SCHOOL PSYCH, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORELLANA
Provider First Name:
CRYSTAL
Provider Middle Name:
HELEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SCHOOL PSYCH, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELLIOTT
Provider Other First Name:
CRYSTAL
Provider Other Middle Name:
HELEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRYSTAL HELENELLIOTT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538049523
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3711 OASIS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDDING
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
96003-0307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-275-5480
Provider Business Mailing Address Fax Number:
530-275-5416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3711 OASIS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-0307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-323-7268
Provider Business Practice Location Address Fax Number:
530-275-5416
Provider Enumeration Date:
09/03/2025

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: 103TS0200X , with the licence number:  250167487 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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