Provider Demographics
NPI:1932590593
Name:SAIDI, CRYSTAL
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:SAIDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 MAIN ST APT 328
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5013
Mailing Address - Country:US
Mailing Address - Phone:714-931-4443
Mailing Address - Fax:
Practice Address - Street 1:1825 E THELBORN ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1442
Practice Address - Country:US
Practice Address - Phone:626-915-3844
Practice Address - Fax:626-915-3845
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA29022103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)