Provider Demographics
NPI:1215344585
Name:DAYVOLT, CRYSTAL LYNN
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:DAYVOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:CORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 E ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-1554
Mailing Address - Country:US
Mailing Address - Phone:818-568-5334
Mailing Address - Fax:
Practice Address - Street 1:1415 E ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-1554
Practice Address - Country:US
Practice Address - Phone:818-568-5334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker