Provider Demographics
NPI:1992516504
Name:MUNOZ, CRYSTAL MILAGROS
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MILAGROS
Last Name:MUNOZ
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 1:12677 CANDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-2242
Mailing Address - Country:US
Mailing Address - Phone:951-497-8439
Mailing Address - Fax:
Practice Address - Street 1:12677 CANDLEWOOD LN
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-2242
Practice Address - Country:US
Practice Address - Phone:951-497-8439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician